Mandapathil M, et al. - Retrospective review of neck dissection specimens for nonthyroid malignancy during a 30-year period was undertaken by the experts in order to identify incidental metastatic papillary thyroid cancer (PTC). In neck dissection specimens, 26 patients had an incidental finding of PTC in lymph node(s). Subsequent thyroid ultrasound in 20 patients showed nodules. All patients who had undergone surgery and those under surveillance were free of PTC recurrence at a median follow-up of 48 months. In all patients with incidentally discovered metastatic PTC, evaluation for the detection of a primary thyroid tumor is essential. The decision on surgery or surveillance depends on the characteristics of clinical and radiological tumors and the factors of the patient.