We report a rare case of concurrent medullary thyroid cancer (MTC) medullary and papillary thyroid cancer (PTC) papillary cancer of the thyroid gland with intermixed disease in several of the lymph node (LN) metastases in a patient who was subsequently diagnosed with clear cell renal cell carcinoma (RCC). A 56 year old female presented with dysphagia and was found to have a left thyroid nodule and left superior cervical LN lymph node with suspicious sonographic features. Fine needle aspiration biopsy (FNAB) demonstrated papillary thyroid cancer (PTC in the left thyroid nodule and medullary thyroid cancer (MTC in the left cervical lymph nodeLN. Histopathology demonstrated multifocal PTC with 3/21 lymph nodesLNs positive for metastatic PTC. Extensive c-cell hyperplasia was identified on multiple slideOne LN in the left lateral neck dissection exhibited features of both MTC and PTC within the same node. In the right lobe, a 0.3 cm focus of MTC with extra-thyroidal extension was noted. Given persistent calcitonin elevation, a follow-up ultrasound displayed an abnormal left level 4 lymph node LN. FNAB showed features of both PTC and MTC on the cytopathology itself. The patient underwent repeat central and left radical neck dissection with 3/6 LNs lymph nodes positive for PTC in the central neck and 2/6 lymph nodesLNs positive for intermixed PTC and MTC in the left neck. There was no evidence of distant metastases on computed tomography and whole body scintigraphy, however a 1.9 x 2.5 cm enhancing mass within the right inter-polar kidney was discovered. This lesion was highly suspicious for RCC. Surgical pathology revealed a 2.5 cm clear cell RCC, Fuhrman grade 2/4, with negative surgical margins. She continues to be observed with stable imaging of her triple malignancies.