Insular carcinoma of thyroid is a very rare subtype of thyroid carcinoma wh
ich is characterized by its advanced stage at presentation and aggressive c
linical course. We describe a case of insular carcinoma of the thyroid pres
enting in an unusual fashion with cervical cord compression at initial pres
entation. Cord compression is shown to be due to spinal metastases from vas
cular spread of the tumour and this typifies the high metastatic potential
of this tumour subtype.