A 66 year-old woman had a thyroid nodule incidentally discovered during magnetic resonance imaging (MRI) of the neck to evaluate neck pain. A thyroid ultrasound revealed a solitary 1.1 cm hypoechoic, solid, well-circumscribed nodule with Grade 4 vascularity on Doppler flow and no calcifications. No abnormal lymph nodes were observed. Her thyroid-stimulating hormone (TSH) level was 1.9 mIU/L (normal, 0.5-5.7 mIU/L). Fine needle aspiratory biopsy was performed, and cytology was positive for papillary thyroid carcinoma.