DREAM can still act as intracellular effector of TSH receptor (TSHR), activating the signaling cascade by cAMP (adenosine 3′,5′-cyclicmonophosphate) independently of stimulation by TSH, which is suggested by Rivas and cols., as a possible mechanism of development of multinodular goiter by describing overexpression of DREAM in 10 of 16 human samples (16). The gene discussed is TSHR; the disease is multinodular goiter.