Key Clinical MessageThe occurrence of simultaneous multifocal papillary thyroid carcinoma and mixed medullary‐papillary carcinoma, as far as we know, has not been previously described. We suggest the surgical approach to be driven by the medullary component.AbstractPatient underwent total thyroidectomy with central compartment lymph node dissection. Histological examination revealed a simultaneous multifocal papillary thyroid carcinoma and mixed medullary‐papillary carcinoma. He was disease‐free at 1‐year‐follow‐up.