A 45-years-old manwas diagnosed with occipital bone metastasis of papillary thyroid carcinoma. He presented an eight cm occipital bone mass with two years of evolution. The CT scan showed an81,3 x 52,7 x 61 mmtumour of occipital bone with meningeal, brain and soft tissue invasion. The biopsy confirmed thyroid origin of the mass.Three other osteolytic lesions were noted: left ischium, D4 and L1 with medullary canal invasion.He received a total dose of 20Gy of conformal 3D radiotherapy in 5 fractions, at a daily dose fraction of 4Gy over one week to the four lesions.