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Highlights • The diagnosis of primary malignant tumors is increasingly described with the improvement of life expectancy and the advent of new technologies. • The management must be multidisciplinary and adapted to the condition of each patient. This entity affects elderly people with many comorbidities. • Treatment should be the least aggressive and start with the most aggressive tumor. • The elderly, a family history of neoplasia and smoking appear to be the factors favoring the appearance of multiple synchronous tumors. Our patient was an elderly person and a heavy smoker, Introduction The simultaneous appearance of several primary cancers is rare. Presentation We report the case of a 77-year-old man admitted to the Mohammed V military hospital in Rabat (university hospital) and presenting severe dysuria on the PSA test which was 10.83 ng / ml. The prostate MRI performed revealed a suspected lesion. He had left renal colic associated with hematuria two weeks later. A CT scan of the abdomen and pelvis performed revealed a 14 × 12 mm middle and lower calyx excretory tract tumor on the left and a 27.6 × 26.4 lower right polar kidney tumor enhanced after injection of product from contrast. The prostate biopsy confirmed an adenocarcinoma of the prostate. He first underwent a left nephroureterectomy for the tumor of the excretory tract, followed by radiotherapy combined with hormone therapy for his adenocarcinoma. It was decided to monitor the tumor of the right kidney. Discussion The literature contains only a few case reports and reviews of patients with three or more synchronous malignancies. We report the case of a man in whom three different cancers were found over a period of three months. The patient had no significant medical history, such as a family history of cancer or chemotherapy other than old age and chronic smoking. Therefore, we suggest that these factors may favor the occurrence of several synchronous primary cancers. Conclusion There is no consensus on the treatment of multiple malignant tumors. Patient care is individual, by a multidisciplinary team, accounting for the type and the stage of each tumor with a more conservative approach.