A 13-year-old Saudi boy was referred to the paediatric endocrinology clinic for evaluation of rapidly progressive goitre with weight loss of 6 months duration. A clinical diagnosis of possible thyroid malignancy was made. On exploration the mass was found to be tuberculous in origin, attached to the thyroid gland, and responded to partial excision and anti-tuberculous chemotherapy. Tuberculosis should be considered in the differential diagnosis of anterior midline neck masses.
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