The thyroid gland is characterized by significant anatomical variability, which may lead to difficulties in diagnostic and treatment outcomes. The pyramidal lobe is the most common variation present in up to 30% of the population. Literature has witnessed research on different variations of the pyramidal lobe, preference for the lobe from which it arises, gender preference, etc. Understanding such variations is essential for successful treatment outcomes for thyroid diseases. This short review was aimed to highlight embryological aspects of the thyroid gland, variation of its pyramidal lobe and present a rare case of demarcated left lobe, pyramidal lobe, and an associated cyst.
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