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CT findings of irAEs is important for early detection and accurate diagnosis of potentially serious immunotherapy toxicities. Minimally invasive thyroidectomy (MIT) is technically less damaging tissue and is better cosmetic results with small neck scar, decreasing postoperative pain and neck discomfort. We present the experience of MIT without remote access with case of grossly extra-thyroidal extension positive papillary thyroid carcinoma. A 44-year-old, female presented 1.6 cm irregular hypoechoic nodule at upper pole in Right thyroid