Among the 3 imaging techniques tested simultaneously, FCH PET/CT was superior for accurate preoperative localization of parathyroid adenomas, especially for ectopic or small parathyroid lesions.

Parathyroid carcinoma (PTC) is a rare endocrine tumor and uncommon cause for primary hyperparathyroidism. 18 F-fluorocholine (FCH) positron emission tomography and computed tomography (PET/CT) has shown promising results in the detection of parathyroid adenoma, though its role in PTC is undefined due to the paucity of incidence. The authors in this case report discuss the possible complimentary role of FCH PET/CT with 18 F-fluorodeoxyglucose PET/CT in the evaluation of the management of suspected recurrence, since this rare entity has high loco-regional and distant recurrence of the disease.

F-Fluorocholine (FCH) PET/CT is evolving as a functional imaging modality for the preoperative imaging of abnormal parathyroid tissue(s) helping to localize eutopic and ectopic parathyroid tissue and limit the extent of surgery. FCH PET/CT may show incidental uptake in various thyroid lesions necessitating further evaluation, whereas the role of F-fluorodeoxyglucose (FDG) PET/CT in the detection of incidental thyroid nodules is well documented. The case of a middle-aged woman with dual pathology of parathyroid adenoma and papillary thyroid cancer detected on FCH and FDG PET/CT is presented.

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