Figure 3.

a-c: After 8 courses of bevacizumab+XELOX (capecitabine, oxaliplatin) therapy, lung metastases showed a transition to progressive disease. Thereafter, bevacizumab+FOLFIRI (irinotecan, l-leucovorin, 5-fluorouracil) therapy was started. On day 4 of course 5, the patient experienced pain on the left side of his chest and was admitted to our hospital. CT showed infiltrative shadows with cavities in the left S1+2 through S4 lung field. Although inflammatory changes were considered, because the blood test results for inflammatory markers were unremarkable and infection was ruled out, we speculated that a rupture of pulmonary metastatic lesions occurred, leading to bleeding.