Clinical data: a 65-year old woman underwent bilateral subtotal lobectomy for nodular goiter 28 years earlier. She was referred for an evaluation of a recurrent nodule.

Ultrasonography: the right thyroid was composed of a large hypoechogenic area. It was divided to smaller areas by normal parenchyma and was surrounded with an echonormal rim. The pattern did not fit a nodule in a pathological sense.

Cytology: resulted in benign colloid goiter.

Comment: this is a very characteristic finding of an operated thyroid. The echonormal rim, the uneven surface of the hypoechogenic lesion, the multiplicity of the hypoechogenic areas are all arguing for this pattern being normal.