Shanda Blackmon, M.D., M.P.H., professor of surgery and thoracic surgeon at Mayo Clinic in Rochester, Minnesota, shares a case presentation on VATS left lower lobectomy in the setting of multiple lung lesions. Multifocal lung cancer is an increasingly common clinical scenario, but there is a lack of high-level evidence for its optimal treatment. Staging is an important first step in the management of such pathologies. As many as 6% of patients may present with unsuspected cranial metastases. Minimally invasive resections, parenchymal-sparing approaches and multidisciplinary care are the central themes emphasized in this case report and review of the literature.