Clinical presentation: A 41-year-old man requested an evaluation of a nodular goiter. After the discovery of a nodule 3 years ago, aspiration cytology was performed and 3 mL cystic fluid was removed. The patient has noticed several weeks before the present examination that the cyst has refilled.

Palpation: a not firm nodule in the right lobe.

Result of blood tests: TSH 1.96 mIU/L.

Ultrasonography. The thyroid was echonormal. The right lobe had a cystic nodule with echonormal solid components. The subtype of the cyst is difficult to define: it is either a spongiform or a peripheral-type cyst, the former seems to be more probably.

We tried twice to remove cystic fluid from the nodule, but we have failed and only a minimal amount of thick material could be aspirated. Aspiration cytology resulted in benign cystic-colloid goiter.