Detection of brown tumors by [18F]F-choline PET/CT performed in a patient with secondary hyperparathyroidism.

Brown tumours are rare bone lesions occurring in patients with severe hyperparathyroidism (HPT) because of increased osteoclastic activity due to high levels of parathyroid hormone (PTH). We report the case of 30-year-old woman with secondary hyperparathyroidism due to severe chronic kidney diseases who underwent [18F]F-choline PET/CT scan for localization of the hyperfunctioning parathyroid gland before surgical treatment. [18F]F-choline PET/CT scan showed increased choline uptake in the lower left parathyroid gland and in multiple bone lytic lesions. Multiple focal choline uptake in bone corresponded to brown tumours - fibrous osteitis cystica.