Polymyalgia rheumatica (PMR) is an inflammatory disease which mainly affects the elderly and is highly responsive to steroid therapy. PMR can be associated with giant cell arteritis as well as with malignancy. Three cases of malignant neoplasms of the digestive apparatus beginning with a clinical picture similar to that of the "idiopathic" PMR, but with poor response to steroid therapy are presented. In one case the primary neoplasm was found only at the autopsy. These observations suggest that a careful clinical evaluation and a long follow-up are necessary for a correct diagnosis of "idiopathic" PMR