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Cutaneous metastases from thyroid carcinomas, although uncommon, have been previously reported and are usually found in association with evidence of disseminated disease. We report a 75-year-old male who presented with a 4-cm reddish violaceous nodule on the left temple and a clinical history significant for papillary carcinoma of the thyroid. Microscopic examination of a 4-mm punch biopsy revealed a poorly circumscribed neoplasm with focal epidermal connection and multiple cystic cavities and papillary projections. This case report describes a solitary cutaneous lesion as the first evidence of disseminated neoplastic disease in a patient with no other clinical evidence of concurrent metastases. The histology of the lesion was unusual in that it mimicked a primary cutaneous neoplasm. Mahalingam M, Bhawan J. Metastatic papillary carcinoma of the thyroid? [ABSTRACT FROM AUTHOR]