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We read with interest the paper by Canto and coworkers recently published in Gut that provided guidelines for the management of individuals with a high risk for pancreatic ductal adenocarcinoma (PDAC).1 Although indications for surgery are discussed, no recommendations are given regarding the extent of surgery, that is, partial pancreatectomy (PP) or total pancreatectomy (TP), in cases with a small screen-detected PDAC. This is an important issue because it seems very likely that a hereditary background increases the risk for a second primary cancer of the pancreas. Here, we describe two high-risk individuals who developed a second primary tumour after a PP of an early-stage cancer.
Patient 1 is a 62-year-old woman with the common Dutch ‘p16-Leiden’ founder mutation in the CDKN2A gene and a medical history of melanoma at age 56. This patient was enrolled …
Contributors Design of manuscript: TPP, HFAV. Writing of first draft of manuscript: TPP, HFAV, DKB. Editing the first draft and approving the final draft of the manuscript: DKB, EPS, EM, BAB, HFAV.
Funding This work was supported by the ZOLEON foundation (no. 12.09 to HFAV).
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.