Recently, some studies reported that many genes, including BRCA2, ATM, POLD1, PABL2, SMAD4, and so on, played an important role in the occurrence and pathogenesis of MPMTs.[39–41] Specifically, the germline mutations of BRCA1/BRCA2 were associated with increased risk of breast, ovarian, stomach, colorectum, uterus, and pancreas cancers. The gene discussed is SMAD4; the disease is pancreatic neoplasm.