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Autopsies series demonstrate a prevalence of occult thyroid carcinoma ranging from 5-28% suggesting that a large population harbor foci of microscopic carcinoma that are of no clinical significance. There is a female predominance of approximately 3:1 and it is the most common endocrine malignancy. Thyroid cancer can occur at any age although it is most common after age 25 and its virulence increases significantly as a function of age. The majority of patients present with an otherwise asymptomatic thyroid nodule. The prevalence of a thyroid nodule in the general population ranges from 4 – 7% and the vast majority of these nodules are benign. The diagnostic goal is to distinguish benign from malignant thyroid nodules.