We performed surgery on 4 patients who had previously undergone left pneumonectomy and presented a second pulmonary lesion (3 lung cancers; 1 metastasis from colon cancer). Patients were aged between 52 and 79 years; 3 were men. Wedge resection was performed in 3 patients and segmentectomy in the other. Preoperative forced expiratory volumes in the first second were 1940 mL (72%), 576 mL (29%), 1390 mL (63%), and 2370 mL (63%). There was no perioperative mortality; 1 patient presented an air leak for 7 days. Two patients were alive and disease-free at 12 and 15 months, and 2 died from causes unrelated to the tumor at 52 and 183 months. There was no deterioration in the quality of life. In selected cases, patients with a second tumor in a single lung can be treated surgically with little or no mortality and with a prolonged survival.