Locally advanced pancreatic adenocarcinoma in complete response after systemic chemotherapy

Patient presented with painless obstructive jaundice. Imaging studies revealed a pancreatic mass with features of locoregional vascular invasion. Biliary drainage was performed via Endoscopic Retrograde Cholangiopancreatography (ERCP), and endoscopic ultrasound-guided biopsy confirmed a poorly differentiated pancreatic adenocarcinoma. Chemotherapy with gemcitabine and nab-paclitaxel was initiated, with excellent clinical tolerance. The patient showed a progressive response, with complete disappearance of the lesion and normalization of tumor markers. A subsequent PET-CT showed no pathological uptake, consistent with a sustained complete response. This case is notable for the exceptional response to systemic therapy alone in a tumor type typically resistant to chemotherapy, where surgical resection remains the only potentially curative option. A particular molecular sensitivity to treatment is suspected. This case underscores the need for improved early diagnosis and personalized therapeutic approaches.