18F-FAPI-74 PET Findings in a Presumed Benign Bone Lesion Mimicking Bone Metastasis

18 F-FAPI-74 PET demonstrates high tumor detectability but may show uptake in nonmalignant conditions. We present a benign bone lesion mimicking skeletal metastasis on FAPI-PET. Focal tracer uptake was observed in the bone, whereas no corresponding uptake was detected on FDG PET. CT demonstrated a well-defined lytic lesion with a sclerotic rim and no aggressive features. Long-term follow-up imaging showed no interval growth or morphological progression. Although histopathologic confirmation was not obtained, the lesion was considered benign based on radiologic stability. This case highlights a potential diagnostic pitfall of FAPI-PET and the importance of correlation with CT morphology, FDG findings, and clinical course.