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The thyroid gland may show anatomical variations related to embryonic developmental stages. Persistence of the thyroglossal duct is the cause of most variations in the thyroid gland, which are seen as cyst or ectopic thyroid tissue formation and the pyramidal lobe. The presented case is a patient with Graves' disease showing two pyramidal lobes at the right lobe of the thyroid gland, which is extremely rare on presentation.doi:10.15761/nmbi.1000134 fatcat:5lggdal4jrfdnkrsgomrohttta