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We report on a 71-year-old woman presenting with biochemical features indicating recurrent disease in long-term follow-up of left-sided parathyroid carcinoma. She had undergone several surgical procedures including total thyroidectomy, partial resection of the esophageal wall, and curative neck radiation 12 years previously. PET/CT using 18F-fluorocholine revealed high uptake in local relapse in the lower neck, comparable to 18F-FDG, whereas only faint uptake was observed with 18F-fluoroethyl tyrosine. As shown in this case, imaging with FDG and 18F-fluorocholine is feasible in (recurrent) parathyroid carcinoma and clearly superior to 18F-fluoroethyl tyrosine.