He was found to have significant anemia (Hgb 3.5) and elevated carcinoembryonic antigen (CEA) (>994); further workup with CT chest, abdomen, and pelvis demonstrated a large mass in the pelvis arising from the rectum with perirectal lymphadenopathy, numerous hepatic lesions, and few indeterminate sub-centimeter pulmonary nodules. Here, CEACAM5 is linked to anemia.