18F-FCH PET/CT Localizes Ectopic Parathyroid Adenoma

An 18-year-old man presented with hypercalcemia and suspected primary hyperparathyroidism. Initial complete thyroid ultrasound revealed no significant abnormalities. However, ectopic parathyroid hyperfunction could not be excluded. Subsequent 18F-fluoromethylcholine (18F-FCH) PET/CT demonstrated a focus of increased tracer uptake in the anterior superior mediastinum, suggestive of an ectopic parathyroid adenoma. Guided by imaging localization, the patient underwent minimally invasive excision. Postoperative pathologic biopsy confirmed the lesion as an ectopic parathyroid adenoma. This case demonstrates that 18F-FCH PET/CT can accurately locate ectopic parathyroid adenomas, creating an efficient and safe diagnostic and treatment pathway for patients.