Case 273

Medical history

Female patient, 66yo, assisted at the Basic Health Unit had complaints of palpitations and insomnia. Her thyroid presents a hard and painless palpable nodule in the right lobe (about 2.5 cm). Laboratory tests revealed TSH: 0.256 mU / l (NR: 0.4 to 4.5 mU / l), free T4: 0.87 ng / dl (NR: 0.7 to 1.8 ng / dl) anti-TPO: 9.0 U / ml (NR: <15.0 U / ml), antithyroglobulin: <15.0 U / ml (NR: <115 U / ml) and TRAb: 0.30 IU / l (NR: up to 1.75 IU / l). Radioactive Iodine Uptake Testing with I-131 was requested in the follow-up propaedeutics.

Based on the clinical history and images provided, what is the most likely diagnosis?

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