Clinical presentation: a 31-year-old woman discovered a nodule and requested an evaluation.

Palpation: a hard, not freely movable nodule in the lateral part of the isthmus.

Functional state: euthyroidism (TSH-level 0.83 mIU/L).

Ultrasonography: there was a hypoechogenic nodule in the isthmus. The nodule contained microcalcifications and larger hyperechogenic focuses. The latter resembled that frequently observed in medullary cancer. The nodule displayed a type 3 vascular pattern.

Cytological diagnosis: suspicion of papillary cancer.

Histopathology: papillary cancer.