A 35-year-old woman received open thyroidectomy for a thyroid nodule that was confirmed as papillary carcinoma. Whole-body 131I scintigraphy during thyroid ablation demonstrated high uptake in the thyroid bed and multiple focal hot spots in the thorax. SPECT/CT localized the hot spots to the right chest wall and axilla, as well as to the left chest wall. The surgeon recognized these sites to concur with the transaxillary tract used during endoscopic thyroidectomy for nodular hyperplasia 8 years previously. Thus, this case illustrates how thyroidal tissue fragments seeded during endoscopic thyroidectomy can be mistaken for thyroid cancer metastasis on 131I scintigraphy.