The initial diagnosis was not obtained in the setting of negative germline DNA testing for TRHß gene mutation, normal post-menopausal range TSH α-subunit level, and a pituitary MRI scan that was reported as “normal.” The patient underwent total thyroidectomy 1 year later for progressive symptomatic goiter and suspicious nodule which revealed multifocal micro-PTC. This evidence concerns the gene TRH and goiter.