A 75-Year-Old Man With Right-Sided mCRC

Case: A 75-Year-Old ManWithRight-Sided mCRC

Initial presentation

• A 75-year-old Caucasian man presented to his PCP with rectal bleeding, fatigue, weight loss, and constipation

Clinical workup

• Colonoscopy: fungating mass in the ascending colon
• Biopsy: invasive, poorly differentiated adenocarcinoma
• Imaging: CT scan of the chest/abdomen/pelvis showed multiple small liver lesions including a 3-cm mass in right lobe
• Molecular testing on tissue biopsy:
  • KRAS, RAS, andBRAFWT
  • Microsatellite-stable
• ECOG PS 1

Treatment

• Patient underwent a diverting colostomy without complication
• He was started on FOLFOX and bevacizumab
• Follow up imaging at 3, 6, and 9 months showed a partial response
• He was continued on bevacizumab and underwent capecitabine maintenance
• Imaging at 12 months showed 2 new liver lesions (1.2 cm and 3.4 cm)