First examination (1st and 2nd rows of images)

Clinical presentation: a 29-year-old woman was referred for evaluation of infertility.

Palpation: a moderately firm nodule in the left lobe.

Functional state: euthyroidism with TSH-level 1.56 mIU/L.

Ultrasonography. The thyroid was echonormal. There was a nodule in the lower pole of the left lobe. The nodule contained echonormal and moderately hypoechogenic areas and presented a halo sign. There were signs of a type 2 vascular pattern.

Cytology was performed and resulted in follicular tumor without significant atypia.

A combined clinical-ultrasound-cytological diagnosis was follicular tumor with less than 1% risk of carcinoma.

The patient decided to undergo follow-up instead of immediate surgery.

Second examination 2 years later (3rd row of images)

Summary of follow-up: the patient underwent yearly ultrasound examination. The nodule was unchanged, he had no complaints.

Functional state: euthyroidism with TSH-level 1.49 mIU/L.

Ultrasonography: the ultrasound presentation of the thyroid was unchanged.
The volume of the nodule was 0.79 and 0.81 mL, at the first examination and at the 2-year follow up, respectively.

Suggestion: to continue the follow-up with ultrasound and TSH determinations every year.