To report a case of melanoma metastatic to the thyroid gland and to review our experience with secondary neoplasms of the thyroid.

We depict the presentation and treatment of the patient, illustrating pathologic and radiologic findings. All patients with pathologic confirmation of metastatic tumors of the thyroid undergoing thyroidectomy at the Massachusetts General Hospital were reviewed (1995- 2008).

A 59-year-old male presented with malignant melanoma of the scalp. Two months following his melanoma excision and lymphadenectomy, he underwent a hemi-thyroidectomy for fine-needle aspirate positive solitary metastasis. He initially did well, but on follow-up was noted to have diffuse metastases and expired from his disease eight months following initial diagnosis. Institutional review revealed 13 additional patients with pathologically confirmed secondary thyroid tumors.

FNA remains an indispensable diagnostic tool. Palliation from local compressive symptoms is an indication for surgery and long-term survival is seen in some patients undergoing resection of isolated metastases.