The patient is a 48-year-old man with a history of a rectal adenocarcinoma (cT3N2bM0) diagnosed 9 years prior. Following neoadjuvant chemoradiotherapy, low anterior resection, and 6 cycles of adjuvant FOLFOX therapy (fluorouracil, leucovorin, and oxaliplatin), he had developed a lung metastasis (KRAS wild type) 1 year later. He subsequently developed multiple lung metastases treated with palliative local interventions (lobectomy, radiofrequency ablation) and 4 lines of chemotherapy. Owing to symptomatic lung disease, he was enrolled in a clinical trial (NCT03502733) following informed consent and achieved a confirmed partial response. After 9 months, contrast computed tomography restaging scans noted a new, 1-cm posterior subglottic lesion of unclear origin (Figure, A). He had no shortness of breath or noisy breathing, dysphagia, voice change, or hemoptysis. A partial response was maintained without evidence of progression of lung disease.