Interestingly, a number of local and specific risk factors for both neoplastic and infectious disorders were recognized by caregivers (tobacco smoke, long-term inhalatory substance abuse, in particular cocaine, and a half-professional mushroom-truffle search and evaluation also by systematic smelling). Although an appropriate and timely diagnostic workup carried out with repeated, combined computerized tomography, magnetic resonance imaging, and fiberoptic rhinoscopy with multiple biopsy and histopathologic studies, the final diagnosis of a combined, dual neoplastic-infectious pathology occurred only after a demolitive surgical intervention and subsequent pathology studies. Despite a correct antimicrobial therapy, and an associated radiotherapy and cytotoxic chemotherapy schedule, a rapid dissemination of multiple secondary lesions to the brain rapidly led our p to death.