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A 79-year-old man underwent 18F-choline PET/CT for biochemical recurrence of prostate cancer. PET/CT images showed an area of elevated radiopharmaceutical uptake in a left pelvic node. In addition, a small focus of increased radiolabeled choline accumulation was seen in a small nodule of the right breast, which was later histologically characterized as an infiltrating ductal carcinoma. In this patient, choline PET/CT was critical in localizing prostate cancer recurrence and identifying a second unsuspected malignancy.