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Surgical exploration revealed extensive peritoneal carcinomatosis within 3\u2009weeks, with bowel involvement devoid of necrotic changes. Molecular analysis identified a KRAS G12D mutation and homozygous deletion of the CDKN2A\/B tumour suppressor genes. This case exemplifies a hyper-aggressive PDAC phenotype with fatal outcomes, termed \u2018flash carcinomatosis\u2019, whereby tumour biology substantially exceeded standard diagnostic timelines, resulting in a highly truncated course culminating in mortality.<\/jats:p>","DOI":"10.1136\/bcr-2026-272110","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:20:49Z","timestamp":1778682049000},"page":"e272110","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fulminant 'flash' peritoneal carcinomatosis in pancreatic ductal adenocarcinoma: clinical implications of co-occurring oncogenic mutation and tumor suppressor homozygous loss"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7263-8889","authenticated-orcid":false,"given":"Harold","family":"Coley","sequence":"first","affiliation":[{"name":"Osteopathic Medicine, Campbell University, Buies Creek, 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