Clinical presentation: a 75-year-old woman was referred for an evaluation of a slowly growing nodular goiter known for more than decades. The patient noticed difficulties in swallowing in the last few months.

Palpation: a multinodular goiter.

Functional state: euthyroidism with TSH-level 0.12 mIU/L, FT4 17.9 pM/L.

Ultrasonography: a multinodular goiter was found. The thyroid was hypoechogenic and contained multiple hyperechogenic nodules.

Cytology: was performed from a hypoechogenic part of a hyperechogenic nodule and disclosed benign colloid goiter.

The patient was operated because of compression signs.

Histopathology: disclosed benign, hyperplastic nodules.