Clinical data: a 59-year-old woman requested evaluation of a nodular goiter known for 7 years. The nodule was discovered by her family physician. Except for palpation no examination was performed. The patient noticed a slow increase in the nodule located in the isthmic part which caused cosmetic problems.

Palpation: a not firm nodule in the isthmus. The right lobe was also nodular on palpation.

Functional state: euthyroidism (TSH 2.88 mIU/L).

Ultrasonography. The thyroid was echonormal. There were multiple moderately hypoechogenic nodules in the right thyroid causing a micronodular appearance. There was a relatively larger hyperechogenic nodule in the isthmus. The left lobe contained a hypoechogenic lesion, which presented blurred borders, microcalcifications and a type 3 vascular pattern.

Cytology was performed from the hypoechogenic lesion in the left thyroid. The FNAC was not diagnostic, a repeat FNAC three weeks later resulted in benign follicular proliferation.

Suggestion. There was no indication of surgery except for cosmetic reason. The patient decided to continue follow-up.