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A 20-year-old patient consulted for a thyroid nodule recently discovered on self-examination.

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Ultrasound shows  a heterogeneous highly hypoechoic nodule with lobulated outlines of non-downstream shape compatible with an EU TIRADS score of 5 suggestive of papillary carcinoma.

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Elastography is pathological with an elasticity greater than 70 K Pa.

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Also presence of adenopathies of metastatic aspect on the level of lymph node territories IV and VI.

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Fine needle aspiration is in favor of a malignant lesion (Bethesda 6) with lymph node metastases.

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Patient operated: total thyroidectomy with lymph node dissection.

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Diagnosis: Papillary carcinoma with lymph node metastases.

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