GISTs are the most frequent mesenchymal tumors of the gastrointestinal tract; they rarely metastasize to lymph nodes. A 59 year old man was observed. The patient presented an acute abdomen attributable to perforated GIST located at about 40 cm from Treitz. A laparotomy with segmental bowel resection and a side-to-side anastomosis were performed. Five mesenteric lymph nodes, one of which was metastatic, were harvested during the surgical procedure. The casual presence of lymph nodes allowed us to document nodal metastases.