A 56-year-old woman presented with a mass lesion on the right occipital bone underwent total resection of the tumor. An adenocarcinoma with immunostaining positive for thyroid transcription factor-1 and thyroglobulin was found. An ultrasound/thyroid scan detected a hot nodule of 9 mm in the right lobe. Fine needle biopsy revealed the similar histological findings with the previous bone resection material. Then, a total thyroidectomy was performed. Histopathologic examination revealed clear cell variant of papillary thyroid microcarcinoma. She received 7.4 GBq of I-131. On posttherapy scan, metastatic focuses were seen in the left lung and soft tissue between the left paravertebral muscles.