A 42-year-old woman was diagnosed with a KIT-positive high-risk GIST of the jejunum (18 cm diameter, 50 mitoses/50 high-power field) with synchronous peritoneal metastasis. She underwent segmental resection of the jejunum and duodenum, infragastric omentectomy, pelvic peritonectomy and excision of the bladder peritoneum resulting in complete removal of gross disease which was then confirmed by 18F-FDG-PET. She was put on postoperative IM 400 mg/day. Progressive recurrent peritoneal disease was diagnosed and resected 8 months later, followed by dose escalation of IM to 800 mg/day. At 16 months from initial diagnosis, 1 suspicious PET-positive supraclavicular lymph node was removed surgically and showed caseating granulomatous inflammation consistent with tuberculosis. PCR examination confirmed infection with Mycobacterium tuberculosis (fig. 1, fig. 2). Bronchoscopy with bronchoalveolar lavage (BAL) was performed, but PCR and culture were negative for M. tuberculosis. She was started on antituberculous triple therapy with isoniazid, rifabutin and pyrazinamide for 2 months, followed by isoniazid and rifabutin for an additional 4 months. Throughout, IM levels were monitored to ensure sufficient IM exposure during the antituberculous treatment. IM 800 mg was continued for a further 8 months and then had to be stopped because of intra-abdominal progression. During the next 15 months, the patient was switched to sunitinib, sorafenib and nilotinib because of progressive disease. There was no evidence of reactivation of tuberculosis until her death 29 months after initial diagnosis.