The relationship between lung cancer and bullous lung diseases has been described in the literature. Herein, we presented a 45-year-old male patient who was asymptomatic when bilateral bullae and bilateral synchronous primary lung adenocarcinoma were detected. Computed tomography revealed a giant bulla in the upper right lobe with a nodular lesion in the bulla wall, and multiple bullae in the upper left lobe with a nodule in the parenchyma adjacent to the bulla. Initially, malignancy was not considered. Pulmonary function test was restrictive. Thoracotomy was performed for the giant bulla in the right upper lobe. Frozen section analysis of the nodular lesion in the bulla wall revealed poorly differentiated adenocarcinoma. Upper right lobectomy was performed. Mediastinal lymphadenopathy was not observed. Two weeks later, the patient underwent a left thoracotomy for the intraparenchymal nodule. Adenocarcinoma was reported on frozen section analysis and upper left lobectomy was performed. Following surgery, the patient received chemotherapy. No recurrences were detected within a follow-up period of 20 months. This is an interesting case showing the relationship between bullous disease and lung cancer, reminding that bilateral synchronous primary lung cancer may be encountered in bullous lung disease.