Thyroid collision tumors refer to the presence of two or more distinct histological types of malignant tumors within thyroid tissue. Clinically rare, radical surgery is the preferred treatment approach. However, there is currently no treatment consensus for managing postoperative recurrence and metastasis, presenting significant clinical challenges. Our department recently admitted a patient with bone metastasis following thyroid collision tumor resection. One year prior, the patient underwent total thyroidectomy and bilateral functional neck lymph node dissection. Postoperative pathology confirmed papillary thyroid carcinoma (PTC) combined with medullary thyroid carcinoma (MTC). Short-term postoperative follow-up demonstrated satisfactory efficacy, achieving anatomical cure. At 12 months post-surgery, biochemical and structural recurrence primarily involving bone metastases emerged. Following six cycles of anlotinib (12 mg) treatment, bone lesions shrank and tumor markers decreased significantly, suggesting anlotinib holds potential value in treating postoperative progression of such collision tumors.