We report a case of a young adult affected by an adenocarcinoma of the ascending colon with synchronous, unresectable liver metastases, diagnosed on April, 2011. The patient received a first-line of bio-chemotherapy with standard folfox regimen in association with bevacizumab. Deriving from which a good partial remission of the disease with its conversion to operability; so he underwent a right hemicolectomy with liver metastasectomy. Eleven months after radical surgery, the patient experimented an intrahepatic progression of the tumour, so he started a second-line therapy with FOLFIRI regimen plus aflibercept. Six months later than the beginning of the treatment he underwent a second liver metastasectomy. He subsequently received further twelve months of the same regimen. The patient is still alive forty-six months later than the diagnosis of the disease, expressing a good performance status and he's on fourth-line chemotherapy due to a relapse of its tumour.