We present the case of a 53-year-old man with tall cell variant of papillary thyroid carcinoma that metastasized to the pancreas. The pancreas is a unique site of metastasis for differentiated thyroid cancer. The lesion in the neck and lung concentrated radioiodine, whereas the intrapancreatic lesions did not. Discordance between radioiodine studies and serum thyroglobulin in follow-up of patients with differentiated tall cell is reviewed and discussed.