MSH6 and familial pancreatic carcinoma: In a recent NGS analysis of 53 hereditary pancreatic cancers without any known predisposition gene, one MSH2 and MSH6 germline mutation was described each.52 All 7 tumors with MSI among 833 pancreatic cancers (0.8%) identified in a recent study by Hu et al. using NGS sequencing were found to harbor germline mutations in the MMR genes.36 The concept of a possible germline involvement in pancreatic cancers with MSH6 and/or MSH2 expression loss is also supported by our findings.