case_images: PMC11831959_01
case_images: First thyroid ultrasound. A. Transverse view of the thyroid gland showing a multinodular goiter; B. Left thyroid lobe nodules, the largest of which measures 5.2 cm; C. Right thyroid nodules, the largest of which measures 2.0 cm
case_images: cureus-0017-00000077621-i01.jpg
case_images: PMC11831959_01_cureus-0017-00000077621-i01.jpg
case_images: FIG1
case_images: Diagnostic imaging revealed a multinodular goiter: three nodules in the left thyroid lobe and five nodules in the right thyroid lobe (Figure 1).
case_images: Second thyroid ultrasound. A. Transverse view of the thyroid gland showing a multinodular goiter; B. Left thyroid lobe nodules, the largest of which measures 2.6 cm; C. Right thyroid lobe nodules, the largest of which measures 3.8 cm
case_images: cureus-0017-00000077621-i02.jpg
case_images: PMC11831959_01_cureus-0017-00000077621-i02.jpg
case_images: FIG2
case_images: Repeat serial thyroid ultrasounds were obtained twice yearly; 13 months after the initial FNA, some nodules increased, and some nodules decreased in size (Table 1, Figure 2).
case_images: Histology of thyroid tissue obtained during total thyroidectomy. A. Medium-power view showing infiltrative growth of squamous morules of tumor cells (hematoxylin and eosin stain); B. High-power magnification view of solid areas of tumor with cribriform pattern (hematoxylin and eosin stain); C. High-power magnification view showing diffuse and strong nuclear and cytoplasmic staining of infiltrating tumor cells (beta-catenin immunohistochemical stain)
case_images: cureus-0017-00000077621-i03.jpg
case_images: PMC11831959_01_cureus-0017-00000077621-i03.jpg
case_images: FIG3
case_images: Due to the unusual appearance of the lesion (Figure 3), with squamoid morulae, the final pathology was deferred to expert consultation at the University of Pennsylvania.