A case of a 71-year-old man with dyspnea attacks, weight loss and astheno-adynamia syndrome is presented. A 7.7 x 6.4 cm well-delineated tumor is found intraoperatively in the superior lobe of the left lung towards the posterior mediastinum. The tumor cells resemble hepatocytes histologically and show expression for alpha-fetoprotein. Diagnosis primary hepatoid lung adenocarcinoma is made. Pericellular basal membrane-like material is found on electron microscopy. A clinico-morphological discussion regarding the biological behavior and prognosis of this rare tumor is presented.