Background Factitious disorder is where patients repeatedly seek medical care for feigned illnesses in the absence of obvious external rewards; ‘Munchausen's syndrome’ is the historical name for this disorder. Method We report on a case that was presented to a tertiary oncology center as a suspected rare bone cancer. Results and Conclusions Psychosocial clinicians working in oncology settings should be aware of the complexities of diagnosing factitious disorder in cancer settings where empathy is prominent and suspicion unusual. Moreover, comorbidity can cloud the diagnosis (in this case substance abuse), and, even when accurately diagnosed, there are no evidence‐based management approaches to offer to the patient. What seems to linger most after the patient is discharged, usually in a huff, are strong counter‐transference feelings and substantial medical bills. Copyright © 2015 John Wiley & Sons, Ltd.