Comprehensive molecular profiling of each tumor—including assessment of KRAS, TP53, BRCA2, PALB2, and CDKN2A status—can differentiate independent primary tumors from intrapancreatic spread, inform adjuvant treatment options (e.g., consideration of modified FOLFIRINOX or PARP inhibitors in cases with germline mutations), and guide familial risk assessment. Here, PALB2 is linked to neoplasm.