A 56-year-old female presented with a history of breast cancer treated with surgery and chemoradiotherapy 9 years ago. The previous year she started experiencing abdominal pain and the thoracic-abdominal CT scan revealed a solid mass in the pancreas 30×40 mm in size. Ultrasound-guided fine-needle biopsy confirmed adenocarcinoma uT4N1 in the pancreatic neck with vascular infiltration. The patient received neoadjuvant therapy with Gemcitabine and paclitaxel with following radiotherapy. Whipple procedure was performed and the histopathological study revealed pancreatic adenocarcinoma pT3N0. The adjuvant therapy with Gemcitabine was prescribed. The follow up examination identified liver metastases; the BRCA test confirmed the presence of BRAC1 mutation. Finally, the patient received chemotherapy with Folfirinox with good response and no signs of metastatic disease progression.
A 46-year-old female presented with jaundice and bilirubin level up to 6.1 mg/dl. Her sister had oncological history of breast cancer. Thoracic-abdominal-pelvic CT was performed and ultrasound-guided fine-needle biopsy was suggestive for adenocarcinoma uT3N1 in the head of pancreas. The patient underwent the placement of biliary metallic stent and received 7 cycles of neoadjuvant therapy with folfirinox and subsequent radiotherapy. The Whipple procedure was performed and pathological examination revealed complete pathologic response (). The adjuvant therapy with Gemcitabine was prescribed. For now, the patient remains asymptomatic and with no signs of tumor recurrence after 15 months of follow-up.