It has been a rather leisurely day so far, and the end of your shift is rapidly approaching.

The next patient steps into the room. You are surprised to see that it is Catherine, your longstanding neighbor. After a few pleasantries, you ask her what brought her in today.

She hands over a referral letter. In this, her primary care physician asks you to look into a mass he discovered in her neck, during a routine office visit.

You note that she is 46 years old and completely asymptomatic. Her medical history is unremarkable, and she is not on any medications.