Isolated intrathyroidal metastasis revealing an occult lung adenocarcinoma

Thyroid gland is an uncommon site of tumor metastasis inspite of rich vascular supply. Most of the cases are picked up after the diagnosis or during the work up for the primary. Unexpected involvement of thyroid gland as the first presenting sign in a primary lung adenocarcinoma is an extremely rare, however, clinically significant finding, upstaging the disease. Fine needle aspiration cytology as a primary tool for detecting metastasis in thyroid is a rapid procedure, associated with high accuracy and low morbidity.