This 65-year-old man suffering from hypercalcemia in a context of hyperparathyroidism treated by calcimimetics was referred to our institution to perform an 18 F-fluorocholine PET/CT in order to localize the pathological parathyroid gland(s). We incidentally discovered a brain metastatic pulmonary large cell neuroendocrine carcinoma in addition to a parathyroid adenoma. This case illustrates the value of FCH PET/CT in hyperparathyroidism workup event under calcimimetic treatment, as well as the potential of FCH PET/CT to reveal occult malignancies.
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