A 25-year-old female presented to our patient clinic with complaints of pain and swelling over the dorsum of her right foot for a period of 1 year. Swelling was insidious in onset, gradually progressive and reached the present size. Pain was insidious in onset, intermittent, moderate intensity, dull aching, no radiation, aggravated by walking, and relieved with medications. There is no history of fever, trauma, loss of weight, and loss of appetite. The patient had no other medical comorbidities. On examination, there was a localized ovoid-shaped swelling of 2 by 2 cm over the dorsum of right foot, 7–8 cm in front of medial malleolus, and 5 cm behind the base of 2nd toe. Surface appeared to be smooth. Edge of the swelling was clearly defined. There was no hyperpigmentation of skin. On palpation, there was no warmth and tenderness was present. Swelling had well-defined margins, non-mobile, and hard in consistency. Skin over the swelling was pinchable. There was no enlargement of any regional lymph node. X-ray of right foot AP and oblique () was done which revealed well-defined osteolytic lesion in the center of the intermediate cuneiform, geographic pattern of destruction, narrow zone of transition, and not breaching the cortex. MRI of right foot (,,, ) was done which showed an expansile osteolytic lesion with multiple internal septations in intermediate cuneiform with thinning of the cortex. Patient was planned for surgery, the incision was made over the dorsum of the foot, the bone was approached between extensor hallucis longus and extensor digitorum brevis. The intermediate cuneiform was identified and excised completely and was sent for histopathological examination. There was no extension of the lesion to the surrounding soft tissues. Postop xray () showed the removal of intermediate cuneiform. Microscopic examination showed the presence of focal giant cell-rich lesions with background stromal cells, and areas of hemorrhage were also noted ( and ). The finding in the microscopic picture helped us in narrowing our diagnosis to GCT evolving into secondary ABC. The patient was made to partially weight bear for 1 month and following that full weight bearing was started. The patient was not on any sort of immobilizing splint to the ankle or foot. The patient was followed periodically and by 1-year patient was able to weight bear without pain and there was no recurrence of lesion in the foot. Foot Function Index [] preoperatively was 49% (84/170) and got improved to 5% (9/170) after 1 year postoperatively. Activity limitation scale improved from 13% to 3%.