Conclusion:
Surgical interventions are common in patients with metastatic DTC. Procedures to the neck commonly include completion of thyroidectomy and clearance of nodes from the lateral neck, Procedures to the metastatic sites include debulking and fixation of the spine and metastasectomy. A high index of suspicion is needed while evaluating spinal lesions and the possibility of metastasis from the thyroid needs to be entertained. All patients receive radioactive iodine in conjunction with surgery in high doses with its attendant complications. Most patients receive a combination of therapies in varied sequences and the goal of treatment should be to mitigate complications and improve quality of life since most patients live long in spite of their advanced disease. The role of radiotherapy needs to be defined in large multicentre trials and more experience with targeted therapy is needed to formulate robust guidelines.