18F-Fluorocholine PET/CT Imaging of Brown Tumors in a Patient With Severe Primary Hyperparathyroidism

Clin Nucl Med. 2019 Dec;44(12):971-974. doi: 10.1097/RLU.0000000000002814.

Abstract

Brown tumors are rare skeletal anomalies occurring in patients with hyperparathyroidism and exposing patients to pathological fractures. We report the case of a 26-year-old woman with severe primary hyperparathyroidism (calcemia, 2.9 mmol/L; parathyroid hormone, 59 pmol/L) who underwent F-fluorocholine (FCH) PET/CT before parathyroidectomy. FCH PET localized the hyperfunctioning parathyroid gland and showed multiple foci in correspondence with bone lytic lesions on CT. Those lesions were not visible on the Tc-MIBI dual-phase scintigraphy. The pathology of one of the FCH-positive bone lesions corresponded to a brown tumor related to hyperparathyroidism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Choline / analogs & derivatives*
  • Female
  • Humans
  • Hyperparathyroidism, Primary / complications*
  • Hyperparathyroidism, Primary / surgery
  • Osteitis Fibrosa Cystica / complications*
  • Osteitis Fibrosa Cystica / diagnostic imaging*
  • Osteitis Fibrosa Cystica / pathology
  • Parathyroidectomy
  • Positron Emission Tomography Computed Tomography*
  • Technetium Tc 99m Sestamibi

Substances

  • fluorocholine
  • Technetium Tc 99m Sestamibi
  • Choline