45-year-old male patient diagnosed 12 months ago with cephalopancreatic adenocarcinoma. After a period of non-compliance with medical/surgical treatment, he was staged imaging with a borderline tumour (relative to VMS and SMA) and received neoadjuvant FOLFIRINOX treatment. Fortunately he had a good response and more than a year after the first symptom (jaundice) I was able to perform a radical duodenopancreatectomy with tangential resection of the SMV. (pictured: orange – portal vein; blue – splenic vein; purple – superior mesenteric vein; white – superior mesenteric artery) Conclusion: we should not abandon these patients even if they are not able or do not fully understand the seriousness of their disease . The multidisciplinary approach is essential, giving these patients a chance of survival.

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