• Aline Lariessy Campos Paiva, Vitorino AraujoJoão LuizJLPhD. Assistant Neurosurgeon, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), and Neurosurgeon, Instituto do Câncer Arnaldo Vieira de Carvalho (ICAVC), Oncocenter and Hospital Nove de Julho, São Paulo (SP), Bra, Vinícius Ricieri Ferraz, and Esteves VeigaJosé CarlosJCPhD. Full Professor and Head, Discipline of Neurosurgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil..
• MD. Neurosurgery Resident, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
• Sao Paulo Med J. 2017 May 1; 135 (3): 296301296-301.

Context:Brain metastases are the most common tumors of the central nervous system. Because of their high frequency, they may be associated with rare situations. Among these are tumor-to-tumor metastasis and an even a rarer situation called simultaneous brain tumors, which are more related to primary tumors of the reproductive and endocrine systems.Case Report:A 56-year-old male patient with a history of renal cell carcinoma (which had previously been resected) presented with a ventricular lesion (suggestive of metastatic origin) and simultaneous olfactory groove lesion (probably a meningioma). First, only the ventricular lesion was dealt with, but after a year, the meningothelial lesion increased and an occipital lesion appeared. Therefore, both of these were resected in a single operation. All the procedures were performed by the same neurosurgeon. The patient evolved without neurological deficits during the postoperative period. After these two interventions, the patient remained well and was referred for adjuvant treatment.Conclusions:This study provides the first description of an association between these two tumors. Brain metastases may be associated with several lesions, and rare presentations such as simultaneity with meningioma should alert neurosurgeons to provide the best oncological treatment.

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