Interesting ImagesIncidental Detection of a Small Cell Lung Cancer by 18F-Choline PET/CT Performed for Recurrent Hyperparathyroidism After ParathyroidectomyJacquet-Francillon, Nicolas MD∗; Granjon, Denise MD∗; Casteillo, François MD†; Prévot, Nathalie MD∗; Habouzit, Vincent MD∗Author Information From the Departments of ∗Nuclear Medicine †Pathology, University Hospital of Saint-Étienne, Saint-Étienne, France. Received for publication May 27, 2020; revision accepted June 27, 2020. Conflicts of interest and sources of funding: none declared. Correspondence to: Vincent Habouzit, MD, Service de Médecine Nucléaire, CHU de Saint-Étienne, 42055, Saint-Étienne, France. E-mail: [email protected]. Clinical Nuclear Medicine: February 2021 - Volume 46 - Issue 2 - p e109-e111 doi: 10.1097/RLU.0000000000003246 Buy Metrics Abstract We report the case of a 64-year-old woman with musculoskeletal pain and elevated serum parathyroid hormone who had undergone parathyroidectomy for primary hyperparathyroidism 4 years earlier. An 18F-choline PET/CT scan was performed and incidentally showed an intense uptake in a right upper lobe pulmonary nodule and in the right hilar, mediastinal, and cervical lymph nodes. Histopathological analysis confirmed the diagnosis of a small cell lung cancer. Clinical symptoms and recurrent hyperparathyroidism were therefore consistent with a paraneoplastic syndrome. A complete metabolic response was achieved on 18F-FDG PET/CT scan after chemotherapy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.