A left pneumonectomy has been performed for a gigantic pleuropulmonary neoplasm in an old man who was in satisfactory clinical condition. The only symptom were cough and worasening dyspnoea. Despite the aggressiveness of the tumor, that has high rate of recurrence at 5 years, the patient has been curated with excellent oncological clearance and the best symptom palliation has been reached. Palliative surgery has to be evaluated also on a patient basis and not only on the basis of the risk of morbidity and mortality.