An 83-year old male presented to the emergency department with productive cough and acute shortness of breath. Imaging, biochemical and microbiological studies of the pleural fluid indicated empyema. After antibiotic treatment and tube drainage, symptoms of the patient persisted and he received thoracoscopic decortication. His condition improved gradually, but histopathological examination showed metastatic adenocarcinoma of the lung. Clinicians are alerted to the possible association of malignant tumours and empyema in older patients.