F-18 FDG PET is a useful functional image technique to evaluate the disease extent in many cancers by detecting hypermetabolic lesions. In combination with anatomical imaging tools such as computed tomography (CT) or magnetic resonance image, extra anatomical information could be provided for better lesion localization. However, the relatively lower spatial resolution of the "attenuation correction" CT or respiratory motion artifacts in positron emission tomography (PET)/CT fusion imaging may sometimes fail to correctly portray the real anatomical relationship between the lesion and nearby structures. We presented a case, in which the "attenuation correction" CT incorrectly delineated the anatomical relationship, misleading to an inaccurate impression. We recommend PET with contrast-enhanced CT, with focal full diagnostic CT, or with respiratory gating techniques might be an option in selected cases to avoid this kind of pitfall.