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.
A 60-year-old male presented with jaundice and abdominal pain having elevated liver function indices. Abdominal CT scan demonstrated a lesion in the head of the pancreas measuring 37 mm with common bile duct and hepatic duct dilatation and another lesion in liver compatible with metastases. After echoendoscopy, the findings were staged as uT3N1M1 tumor. The biopsy confirmed pancreatic adenocarcinoma. The patient underwent neoadjuvant treatment with gemcitabine and abraxane, after the follow-up examination, this treatment was changed due to suspected progression of the disease regarding the elevation of CA19-9 serum marker; finally, in 2014, the FOLFIRINOX and radiotherapy were prescribed. The laboratory studies revealed BRCA2 mutation. Until 2018, a response to therapy is preserved with no evidence of metastatic disease.