A 44-year-old man with a papillary thyroid carcinoma without any mutation in right thyroid lobe. Transverse (A) and longitudinal (B) ultrasonographic images show a 3.0-cm solid mass with circumscribed margin, oval-to-round shape, isoechogenicity, parallel orientation, and microcalcifications. This mass was classified as K-TIRADS category 4. After surgery, there was no lymph node metastasis and TNM stage was classified as I. There was no recurrence during 10.9 years of follow-up.