A 64-year-old man came to the PC clinic for a dry cough of two months' duration and an occasional sensation described by the patient: as if his pylorus was "closing up" and he was unable to eat. His family history included the death of his mother and father from tuberculosis (TB). His personal history included: poliomyelitis in childhood, which left a slight deformity in both lower limbs, duodenal ulcus at the age of 35 with no subsequent peptic symptoms, and inguinal herniorrhaphy in 1997. He had been an ex-smoker for 9 years. In the anamnesis, he initially reported occasional retrosternal heartburn lasting minutes, which subsided spontaneously or with antacids, and also a feeling of gastric fullness. Physical examination revealed an asthenic habitus. He was afebrile, eupnoeic and normal colour. Examination of the head, neck, chest and abdomen was normal. At the first visit, his family doctor ordered basic laboratory tests (haemogram and biochemistry) and a chest X-ray and prescribed empirical treatment with omeprazole 20 mg/day. The results of the complementary tests were strictly normal and the empirical treatment was not effective. Simultaneously, the patient consulted an otorhinolaryngologist on his own initiative, who requested an X-ray of the paranasal sinuses, which revealed findings compatible with sinusitis that was treated by the specialist with a course of Cefuroxime-axetil 500 mg/12 h (6 days). Subsequently, one month later, given the persistence of the cough and the recent appearance of a discreet weight loss, her family doctor requested an interconsultation with the pulmonologist, who performed an extended analytical analysis and a faecal occult blood test, looking for pulmonary and digestive pathology. The pulmonologist performed the following complementary tests: mantoux test, which was positive (12 mm) with sputum and urine Ziehl's test repeatedly negative, baseline arterial blood gases, pulmonary function tests (PFT) and methacholine challenge test, fibrobronchoscopy, and thoracic computed tomography (CT). All these tests yielded no pathological findings. Empirical treatment with bronchodilators prescribed by the pulmonologist was also ineffective. The new complementary tests performed by the family doctor showed mild anaemia (Hb: 11.7 g/dl), normochromic normochromic normocytic anaemia with high red blood cell distribution index, thrombocytosis, increased globulins, decreased albumin and an elevated erythrocyte sedimentation rate of 88 mm/hour. The faecal occult blood test was positive. With this new finding, her family doctor requested a consecutive consultation with the gastroenterologist, who performed a colonoscopy and an opaque enema in which the only significant finding was colonic diverticulosis, with no evidence of other digestive pathology. Simultaneously with the follow-up of the digestive symptoms, 3 weeks after the consultation with the pulmonologist, the patient began to suffer from asthenia and his family doctor requested a consultation with the hospital's Internal Medicine Department. At this department, an abdominal CT scan was performed showing a large abdominal tumour with probable gastric organ-dependence and local involvement, which was confirmed by gastroscopy and biopsy. During oral panendoscopy, a pre-pyloric gastric ulcer of benign appearance was found, which was later confirmed by pathological anatomy of a biopsy specimen. The General and Digestive Surgery Department performed an exploratory laparotomy and found a large tumour, probably retroperitoneal, attached to the posterior gastric wall at the level of the fundus and multiple extraperitoneal nodules. Several of these nodules were removed for biopsy and a partial gastrectomy with gastrojejunostomy was performed. The biopsy was reported as an intermediate grade spindle cell sarcoma (grade II), which could be classified as a stromal sarcoma of the gastrointestinal wall. With this diagnosis, he was referred to the internal medicine department for evaluation of adjuvant treatment, which was rejected. After discharge from hospital, the patient received home care with palliative treatment by his family doctor until his death, fourteen months after diagnosis.