Abstract:After failure of cisplatin-based chemotherapy for metastatic urachal carcinoma, a 16-year-old patient presents with diffuse liver-, lung-, and brain metastases. The K-ras mutation is present in the liver as well as in the primary resected specimen. The regimen was therefore changed to bevacizumab, 5-fluorouracil, and irinotecan. This led to a partial response which lasted 7 months.