Multifocal Primary Pancreatic Adenocarcinoma With No Precursor Lesion: A Report of Two Cases

The aim of this clinical case report is to highlight the unusual presentation of pancreatic malignancy in which multiple foci of primary adenocarcinoma involving the body and tail of the pancreas are associated with another primary pancreatic mass of adenocarcinoma in the pancreatic head with no precursor lesions in two cases. A retrospective medical chart review was performed at a tertiary hospital in Riyadh, Saudi Arabia, to identify cases with confirmed multifocal pancreatic adenocarcinoma. Data collected include clinical evaluations and laboratory and imaging results. Informed consent was waived. There was no evidence of multifocal cancer on imaging. The unexpected intraoperative findings and pathology report necessitated a total pancreatectomy for both cases. A negative imaging does not rule out a multifocal pancreatic adenocarcinoma. Such awareness may help in the early detection of pancreatic cancer. Moreover, the presence of more than one primary cancer in one organ is a distinctive phenomena that needs further study.