An adamantinoma is a rare primary tumour of bone. It is usually seen by stomatologists as a tumour of the jaws, although several cases of the long bones, especially the tibia, have been described. The tumour is considered as a low grade malignancy with unknown histogenesis. It has a high rate of local recurrence after resection and metastasizes in part of the cases. This report describes a 41-year-old woman with multiple pulmonary metastases occurring 27 years after the diagnosis of a tibia adamantinoma. The clinical, radiographic and fiber-bronchoscopic findings are presented. The literature of adamantinoma metastasis is reviewed. The need for an early locally aggressive treatment is stressed as the treatment of metastatic disease seems very disappointing.