Papillary thyroid carcinoma is well-known for its low malignant potential with good prognostic outcome. It usually presents as a palpable thyroid mass but scarcely manifests as an isolated cervical lymphadenopathy. A 50-year-old man presented with a huge posterior cervical lymphadenopathy which was suspicious for metastatic papillary thyroid carcinoma on fine needle aspiration cytology. The thyroid gland was clinically not visible or palpable. After computed tomography of the neck, the patient was preceded with total thyroidectomy and right selective lymph node dissection. Histopathological assessment confirmed metastases in the lymph node and papillary thyroid carcinoma in the resected gland. The paper revisits this unfortunate case of huge metastatic posterior triangle papillary thyroid carcinoma, illustrating the surgical outlines and discussing literature review.