Will the shepherd be able to play the alpine horn with that huge goiter (XVI century)?

Purpose: There are many of the representations in iconography of individuals with goiters reported in the literature. Methods: The article describe a unique representation of goiter, as observed by the authors in a sculpture in Italy. Results: In a Nativity, in the upper part of the altar of the Church of the Annunciata, Boccioleto (Val Sermenza, Piedmont, Italy), a horn player with a huge goiter, gladdens the Holy Family. Wooden work by Francesco Antonio d'Alberto, 1694. Conclusion: This is an appropriate example of the iconography of "real goiter," since in this case the sculptor had the aim of showing person with goiter.