Successful resection after neoadjuvant therapy in pancreatic adenocarcinoma

A 59-year-old woman presented with borderline resectable pancreatic adenocarcinoma involving the neck and body of the pancreas. She was treated with systemic chemotherapy followed by chemoradiation, with subsequent downstaging of the tumor by imaging. Subsequent resection had negative margins and negative lymph nodes with only microscopic disease present in the tumor specimen. Neoadjuvant therapy is controversial but could play a role in borderline resectable disease by allowing for higher chance of negative margins at surgery and increasing the chance for cure in these patients. Microscopic disease at time of resection is rare.