Introduction
Thyroid cancer is among the most commonly diagnosed cancers worldwide, and the incidence is increasing1. Differentiated thyroid cancers (DTC) account for most of these cases, of which PTC is the most common subtype with favourable 10-year survival of up to 90-95%1,2. PTC most commonly presents as an asymptomatic thyroid mass or nodule and less commonly with regional or distant metastasis at onset of diagnosis. Up to 20-50% of PTC will involve cervical lymphatic spread and 1-4% involve distant metastasis, with 5 year survival rates reduced to 28% for single-organ and 11% for multi-organ metastasis3. The majority of patients with metastatic disease have single-organ metastasis, most commonly lung (53%), bone (28%), liver (8%) and brain (5%)3. We present a case of an isolated cerebellar lesion as the presenting feature of metastatic PTC with other unusual features, including an incidental finding of microMTC (medullary thyroid microcarcinoma).