Ulcerated breast cancer with single brain metastasis: A combined surgical approach. Clinical presentation at one year follow up – A case report

•Solitary brain metastasis of breast cancer in a patient with neurological symptoms as first presentation is a rare complication.•Simultaneously perform a metastasectomy surgery plus right mastectomy, right axillary dissection and immediate breast reconstruction is unusual event.•Successful combined surgical approach in a stage IV de novo breast cancer patient with single site brain metastasis at one year follow-up.•Combined surgical approach offers the opportunity to treat two different oncological urgencies, reducing the unnecessary repeated surgical and anesthesiologic trauma.