Parathyroid Carcinoma – A Malignant Cause of Metabolic Skeletal Super Scan on Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography

Excessive abnormal tracer uptake in active tracer avid organ(s) with the suppression of physiological background tracer distribution is termed as super scan. Herein, we present an (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT), where the metabolic pattern of skeletal super scan with coexistent parathyroid tumor was seen giving rise to the suspicion of primary hyperparathyroidism. It was subsequently diagnosed as a case of parathyroid carcinoma. Very high levels of serum parathormone in parathyroid carcinoma lead to accelerated bone turn over resulting in metabolic skeletal superscan in FDG-PET/CT which is seldom observed in parathyroid adenoma.