18F-FDG PET/CT metabolic variability in functioning oncocytic parathyroid adenoma with brown tumors

Clin Nucl Med. 2014 Apr;39(4):393-5. doi: 10.1097/RLU.0000000000000380.


A 29-year-old female patient exhibited a solitary neck mass, severe hypercalcemia, and multiple skeletal lytic lesions consistent with metastatic neoplastic disease. Fine-needle aspiration (FNA) cytology of the neck lesion indicated a follicular thyroid neoplasm. CT-guided bone biopsy was non-diagnostic. Subsequent 18F-FDG PET/CT examination demonstrated avid glucose uptake within the neck mass and diffuse bony lesions of variable metabolic activity. Repeat biopsy utilizing PET/CT guidance produced core tissue with classic histologic features of a brown tumor. Postoperative histology revealed an exclusively oncocytic parathyroid adenoma. Atypical radiotracer uptake of this rare functioning adenoma subtype is illustrated with discussion of improved procedural diagnostic yield utilizing PET/CT.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Multimodal Imaging*
  • Parathyroid Neoplasms / diagnosis*
  • Parathyroid Neoplasms / metabolism*
  • Parathyroid Neoplasms / pathology
  • Positron-Emission Tomography*
  • Tomography, X-Ray Computed*


  • Fluorodeoxyglucose F18