The authors report a case of a patient aged 83 who presented with a lipid pneumonia and a primary broncho-pulmonary adenocarcinoma of the left lower lobe. The diagnosis of the lipid pneumonia was confirmed following broncho-alveolar lavage and the autopsy confirms the neoplastic origin of the mass lesion at the left base. The authors report 16 similar cases in the literature between 1943 and 1989.