We report a case of 43-year-old male, presented with sudden onset binocular 
diplopia on lateral gazes. Ocular examination showed features of ipsilateral 
one-and-a-half syndrome. Comprehensive systemic work in conjunction with 
magnetic resonance imaging of the brain illustrated irregular mixed solid and 
cystic lesions in the brainstem, possibly indicative of brain metastases. 
Further imaging revealed hidden renal cell carcinoma as a primary neoplasm, 
which led to secondary manifestations.