Abstract
Hepatocellular carcinoma is the third leading cause of cancer deaths worldwide, with a 5-year survival rate of 20.3%, while colorectal cancer is a major cause of morbidity and mortality worldwide, being the third most common cancer in men and the second in women. In addition, multiple primary tumors, involving cancers at different sites and histologies, occur in 2.4% to 17% of cases. We report a case of a 74-year-old man with colon cancer presented at the Emergency Department with asymptomatic anemia post chemotherapy and surgical intervention two years ago. He reported experiencing paleness, dizziness, exertional dyspnea, and fatiguability for the past month. Therefore, chest computed tomography was performed to rule out pulmonary embolism; however, the image revealed an incidental finding of two hepatic lesions in segment II. After further investigations, the decision was to perform hepatic segmentectomy. Postoperative pathology revealed residual Hepatocellular carcinoma and metastatic colonic-type adenocarcinoma with mucinous differentiation.