Pulmonary adenocarcinoma is one of the major types of lung cancers in which metastasis is not uncommon. Hereby, we report a case of pulmonary adenocarcinoma with multiple muscular, cutaneous, pancreatic and peritoneal metastases. Actually, all these features occurring in one patient makes it an extraordinary case. A rare anatomic variation, double inferior vena cava (IVCs), was another rare manifestation in this case.