Abstract A 26-year-old man presented with right facial pain for more than 20 days. Admission diagnosis was considered as jaw osteomyelitis. CT of the chest before surgery showed multiple bone destructions, which were considered as bone metastases. Then the 18 F-FDG PET/CT was recommended for finding the primary tumor and evaluation of disease extent. 18 F-FDG PET/CT revealed multiple abnormal foci at the skeleton and the left arm. Pathological examination and molecular analysis revealed the diagnosis of clear cell sarcoma. We present a case of clear cell sarcoma with multiple bone metastases, which is an extremely rare tumor.