Clinical data: a 72-year-old woman was referred for an evaluation of a suspected toxic nodule with hyperthyroidism. The patient had lost 8 kg in 4 weeks.

Palpation: a hard, painless nodule in the left lobe of the thyroid.

Functional state: euthyroidism.

Scintigraphy demonstrated a cold nodule

Cytological diagnosis: suspicion of malignancy, probably metastatic carcinoma.

The patient was further evaluated in another hospital. Gastroscopy revealed a tumor.

Gastric biopsy photos: demonstrated in the lower row.

Histopathology : gastric adenocarcinoma.

Histological specimen courtesy of Dr. Laszlo Szabo, Albert Schweitzer Hospital, Hatvan, Hungary.