Total thyroidectomy in HIV positive patient with buffalo hump and taurine neck.

•A multinodular goiter in an HIV-positive with lipodystrophy, buffalo hump and taurine neck.•Needle aspiration biopsy was difficult to use to determine the presence of lipodystrophy.•The goiter was with retrosternal engagement and the ovalization of the tracheal lumen.•Surgical treatment was necessary due to the presence of dyspnea during exercise.•Importance of the perioperative teamwork, in particular to the patient positioning.