Recurrent Colon Cancer with Liver Metastases

November 2012

• A 51-year-old man was referred to gastroenterology for screening colonoscopy.
• Family history includes pancreatic cancer on his father’s side and pre-menopausal breast cancer in his aunt.
• Colonoscopy revealed a 3-cm mass, proximal to the hepatic flexure.
• Biopsy confirmed the lesion to be of adenocarcinoma histology.
• At the time, the patient underwent right hemicolectomy revealing a moderately differentiated tumor. Fifteen lymph nodes were removed and tested negative for metastatic disease, denoting stage T3N0M0 colon cancer.
• The patient healed without complications and received no further treatment.

April 2015

• The patient continued to feel well, except for occasional fatigue and diarrhea.
• Routine evaluation showed elevated carcinoembryonic antigen.
• PET/CT scan revealed several small lesions in multiple lobes of the liver that were PET avid
• Biopsy was performed and confirmed the liver lesions to be metastases from colon cancer
• The patient was referred to a local oncologist and started on infusional 5-FU and oxaliplatin (FOLFOX) in combination with bevacizumab.
• CT scan 2 months after starting treatment showed a partial response to therapy; at 4 months the patients tumor continued to shrink
• Oxaliplatin was discontinued; subsequently the patient received maintenance therapy with capecitabine and bevacizumab, resulting in continued disease control

February 27, 2017

• The patient has had stable disease for 22 months and remains on bevacizumab maintenance therapy.
• He appears generally well and free of symptoms.