A 60-year-old man presented with spindle cell carcinoma of the penis. He underwent surgery and additional positron emission tomography and computed tomography scans to evaluate for possible metastases. Positron emission tomography showed a left inguinal and paravesical hot spot on the right. Only the left inguinal lesion could be confirmed on computed tomography. The patient underwent additional surgery with curative intent. Three months later, the patient underwent repeat computed tomography, which revealed an osteolytic process in the right acetabulum. This lesion corresponded with the right paravesical hot spot on the positron emission tomography scan 3 months earlier.