Differentiated thyroid cancers with metastasis rarely appear initially as spinal cord compression without any symptoms of malignancy. However, we report a case of a 70 years-old woman who presented initially progressive quadriplegia. Magnetic resonance imaging showed severe cervical cord compression with C4 destruction and thyroid hypertrophia. She had a thyroidectomy and C4 corporectomy with cage and plating. The histopathological examination concluded with papillary thyroid carcinoma.