A 52-year-old woman with a papillary thyroid carcinoma with BRAF mutation in right thyroid lobe. Transverse (A) and longitudinal (B) ultrasonographic images show a 2.2-cm solid mass with spiculated margin, irregular shape, hypoechogenicity, non-parallel orientation, and micro- and macrocalcifications. This mass was classified as K-TIRADS category 5. After surgery, central lymph nodes were confirmed as metastases and TNM stage was classified as III. There was no recurrence during 11.4 years of follow-up.