Surgical treatment for metastatic lesions from lung cancer is seldom performed. We have treated three patients with a unilateral adrenal metastasis with adrenalectomy. Simultaneous resection of primary lung cancer and adrenal metastasis was performed in two cases. This is the first report of such surgical management. Adrenalectomy after lung resection was done in the third case. Two of the patients are alive and well more than 5 years after adrenalectomy. These cases are presented, and the literature is reviewed. © 1995 Wiley-Liss, Inc.