Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 6 2026 07 10 399 402 Fereshteh Kamani Department of Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Aidin Esrafilian Department of Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Farzad Dehghani Department of Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Saina Ghadiany Department of Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammadhosein Aghazadeh Department of Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamidreza Movahedi Department of Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2025 03 23 2025 08 27 Hydatid disease is a parasitic zoonosis caused by Echinococcus granulosus, most commonly affecting the liver and lungs. Involvement of the thyroid gland is extremely rare and can mimic more prevalent conditions such as multinodular goiter (MNG). A 26-year-old Iranian woman with a history of consuming contaminated water presented with a painless anterior neck nodule in the thyroid area. Initially diagnosed with multinodular goiter, she underwent total thyroidectomy under general anesthesia. later diagnosed histopathologically as a hydatid cyst of the thyroid, with concurrent cysts identified in the liver and spleen. This case highlights the importance of considering hydatid disease in the differential diagnosis of cystic thyroid lesions, particularly in endemic areas, and discusses diagnosis and management methods. https://acta.tums.ac.ir/index.php/acta/article/view/11607 https://acta.tums.ac.ir/index.php/acta/article/download/11607/6069