Clinical presentation: A 64-year-old woman was presented with a slowly growing multinodular goiter which has been known for 11 years. She had already difficulties in swallowing.

Palpation: a multinodular goiter.

Functional state: euthyroidism (TSH 0.39 mIU/L, FT4 16.6 pM/L).

Ultrasonography: There were several hypoechogenic nodules within an echonormal background. The nodule aspirated was located in the lower part of the left lobe and presented an eggshell calcification.

Cytology resulted in benign, colloid goiter.

Surgery was performed because the size of the thyroid.

Histopathology: benign hyperplastic nodular goiter.

Comment: Multinucleated giant cells can be found in most thyroid diseases. We have found multinucleated giant cells in this case very similar to that observed in de Quervain's thyroiditis. On the other hand, other cytological properties, i.e. the lack of inflammatory cells and the presence of colloid, excluded the possibility of granulomatous thyroiditis.