We report the case of an elderly patient with advanced papillary thyroid carcinoma (PTC) harboring <i>RET-CCDC6</i> fusion with four co-occurring mutations involving <i>PI3KCA</i>, <i>TP53</i>, and <i>hTERT</i> mutations, treated with pralsetinib under a compassionate use program. Here, CCDC6 is linked to thyroid gland papillary carcinoma.