A 75-years-old patient with a history of prostate cancer, previously treated with radical prostatectomy, underwent C-choline PET/CT for restaging due to a rise in the prostate-specific antigen level. The study revealed a focal uptake of C-choline in the esophagus. A subsequent endoscopic examination showed the presence of an esophageal lesion, and after surgery, the histologic diagnosis was mildly differentiated squamous cell carcinoma. In our case, the incidental esophageal uptake revealed by C-choline PET/CT allowed the early diagnosis of an unsuspected esophageal carcinoma.