Thyroid malignancies are rare, accounting for 0.5 to 1.0% of the deaths that occur as a result of malignant disease. In the United Kingdom, the incidence is 4 per 100 000 per annum.1 More than 90% of thyroid malignancies are well-differentiated adenocarcinomas, with papillary carcinoma accounting for 80% of these. Papillary thyroid carcinomas have a 4:1 predominance in women, with the peak incidence between the third and fifth decades of life. Although the majority of these tumors present as a solitary thyroid nodule, they have a propensity for lymphatic spread in 50% of cases at presentation and are often multicentric (30%-50%). Only 5% of patients develop distant metastasis.1