This 70 y/o male presented with a 12 x 8 x 6 cm swelling on the right side of his neck. It had been present for about 2 years but had shown rapid enlargement in the last 3 months. It had variable consistency ranging from firm to cystic. Computed tomography examination revealed a partially cystic tumor located in the right lobe of the thyroid and multiple bilateral enlarged lymph nodes in the neck. The tumor had also invaded cervical esophagus and trachea. True cut biopsies and lymph node biopsy revealed papillary carcinoma. Case courtesy of: Dr. Sanjay D. Deshmukh, Professor of Pathology, Dr. Vithalrao Vikhe Patil Medical College & Hospitals, Ahmednagar, India. Used with permission.