Inclusion criteria:  Bethesda category IV, V or VI following Fine Needle Aspiration; if a patient has a benign tumor following surgery, patient data/ samples will be stored to serve as benign control in potential future projects. Age 18 years and older Surgical candidate Ability to provide informed consent  Exclusion criteria:  History of thyroid cancer Completion surgery candidate Pregnant women or other vulnerable patients (e.g. wards of the state, prisoners)