A 15-year-old boy, presented with a right leg swelling, which increased in size over 2 months. There was no history of fever or weight loss. Radiograph of right lower limb showed a lytic sclerotic mass in proximal meta-diaphysis of right fibula, which on biopsy was suggestive of Ewing's sarcoma. Whole body 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) was performed as a part of staging work-up. Maximum intensity projection (MIP) image [Figure 1a] showed intense focus of tracer uptake in the right leg (arrow) and liver (arrow-head). Axial fused PET/CT images revealed intense tracer uptake in destructive lytic-sclerotic soft tissue mass in upper end of right fibula, with a maximum standardized uptake value (max SUV in milliCurie/kilogram of body weight) of 7.8. An intense solitary focus of FDG uptake was seen in hypodense lesion in caudate lobe of liver [Figure 1c - arrow], which was presumed to be metastatic on the basis of imaging findings. It measured 16 mm in transverse dimensions with a max SUV of 8.2. Rest of the study was unremarkable, except for reactive mediastinal nodes. Subsequently, patient underwent induction chemotherapy for 6 weeks. Follow-up FDG PET/CT study after treatment completion showed complete regression of tracer concentration at primary site in tibia on MIP image [Figure 1b - arrow], as well as reduction in size of the soft tissue mass with post treatment healing changes in the fibula seen on axial CT images. Contrary to this, the focal hepatic lesion in caudate lobe of liver showed significant increase in size and metabolic activity [Figure 1b - arrow head]; measuring 31 mm, with max SUV of 14.6 on axial fused PET/CT images [Figure 1d - arrow]. This prompted a histological correlation and fine-needle aspiration (FNA) was done from the liver lesion. Microscopic examination showed collection of epitheloid cells on Papanicolaou Stain [Figure 2a - arrows and Figure 2b] with pale oval shaped cells showing slipper shaped nuclei [Figure 2b - inset]. These findings were confirmatory for tuberculous etiology. Patient was immediately started on antituberculosis treatment, and follow-up is awaited.