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Synchronous tumours are complex cases, being challenging to distinguish between primary neoplasms and metastatic disease, as well as to accurately determine the origin of metastasis. Although synchronous tumours are relatively rare, its incidence has increased over the years. The authors report on a patient with localized clear cell renal carcinoma and synchronous adenocarcinoma of the lung with solitary brain metastasis, highlighting the uncertainties of the therapeutic approach and the implications to the final outcomes.