Abstract The Polittico della Misericordia (Piero della Francesca, 1444–1462; fresco; Museo Civico di Sansepolcro, Sansepolcro, Italy). The painting includes a self-portrait of the artist in which a thyroglossal cyst is evident. According to Vasari, Piero della Francesca was a calm and wise man, who lived for more than 80 years, supporting the diagnosis of a benign condition. Published online in Wiley Online Library (www.bjs.co.uk). DOI: 10.1002/bjs.11107 Piero della Francesca (1417–1492), an Italian artist of the Renaissance period, did not receive the credit he deserved during his lifetime. He painted several frescos in his home town of Sansepolcro, Italy, after the local government and monastery tried to make the town as attractive as possible, in support of a bid to Rome to be an Episcopal seat. Piero della Francesca painted the fresco Polittico della Misericordia for the altar of the Church of the Confraternita della Misericordia. One of those praying is a self-portrait of the artist. The painter's subjects are arranged symmetrically, which gives a feeling of action, based on careful mathematical and geometrical studies. The importance of Piero della Francesca in the history of art was discovered by English tourists in the mid-19th century, and above all by Austen Henry Layard (1817–1894), one of the most influential archaeologists of the 19th century. During World War II, the commander of the British soldiers received the order to bomb Sansepolcro, which was occupied by the German army. The commander was interested in archaeology and had visited Sansepolcro several times before the war. He therefore decided not to bomb Sansepolcro immediately to avoid destroying the fresco. A couple of weeks later the German soldiers left Sansepolcro, and so the frescos of Piero della Francesca were saved. Read more about the fascinating events surrounding this painting in an essay online.