Thyroid metastasis of lung adenocarcinoma is exceedingly uncommon. Here we present a case of a 72-year-old Chinese male with hoarseness, dysphagia, pain, and palpable thyroid nodules. Ultrasonography-guided thyroid fine-needle aspiration cytology (FNAC) suggested a high-grade follicular-derived thyroid carcinoma (HGFCTC). Molecular analysis identified a