Given the patient’s denial of immune-related diseases, history of toxic exposure, and family history of malignancy, combined with the missense mutation in exon 2 of the KRAS gene, malignant melanoma or intrahepatic cholangiocarcinoma may be associated with adjuvant chemotherapy for bladder cancer and KRAS mutations (21). The gene discussed is KRAS; the disease is urinary bladder carcinoma.