Thyroid cancer accounts for approximately 3% of all new cancer diagnoses per year globally.1 Papillary thyroid carcinoma (PTC) is the most common type, followed by follicular thyroid carcinoma (FTC).1 Recently, the simultaneous appearance of different histological variants in the same patient has been reported, being called combined pattern thyroid cancer, mixed tumors, hybrid tumors or compound tumors of the thyroid gland.2 Epidemiologically, combined pattern cancer is reported in less than 2% of cases, it presents the same proportion in men and women, and the age of presentation is between 18 and 45 years.3 Different associations are found, including mixed carcinomas: a) medullary cancer (CMT) and PTC; b) PTC and fasciitis-like stroma; c) CPT and CFT; and even combinations of CMT, CPT and CFT.4 Several studies suggest a more aggressive clinical behavior, which may be related to the coexistence of multiple patterns of aggressive variants, with early detection and rapid and aggressive treatment being of vital importance. It is based on surgical treatment, moderate-high dose radioiodine and TSH suppression (<0.1mIU/L).4 This achieves a cure rate of up to 66% and survival three years after diagnosis of 90% and 10 years of 80% to 95%.

Background: Breast cancer in the male transgender patient is a great challenge for the medical team, because it is completely different from the usual clinical scenario and there is a lack of scientific knowledge and protocols for managing this special medical situation. Case presentation: We present a 32-year-old transmasculine patient, who developed a palpable nodule on the left breast during the androgen hormonal treatment. Imaging showed a BIRADS5 nodule and core biopsy detected a luminal B breast invasive carcinoma (IDC) with androgen receptor expression.  He underwent a gender reaffirmation oncological mastectomy, chemotherapy and hormonal therapy. Conclusion: In the transgender male scenario, the surgical technique should take into consideration the patient’s aesthetical desire and the oncological result. In this context, it is controversial if the hormonal and oncological therapies should also be changed.