BACKGROUND: Although direct infiltration of papillary carcinoma of thyroid to larynx, trachea and esophagus is well recognized, lymphatic and vascular metastases to larynx and hypopharynx have rarely been reported. CASE REPORT: A case of loco-regionally advanced papillary carcinoma of thyroid metastasizing to the hypopharynx and aryepiglottic fold is presented CONCLUSIONS: Papillary thyroid carcinoma (PCT) is known for their indolent nature and erratic behavior. PCT commonly spreads through lymphatics and vascular spread is rare. However, when occurs it is usually to bone, brain, lungs and soft tissue. Therapeutic decisions in advanced thyroid malignancies are usually difficult especially when there is extra-nodal spread of the tumor. A judicious combination of surgical clearance combined with radioablation is the key to the management of such tumors