75-year-old female patient, with no significant comorbidities or family history of cancer, presented to the Emergency Department with severe abdominal pain and progressive weight loss. Computed Tomography (CT) revealed multiple hepatic lesions, omental nodules and pancreatic mass. CA19-9 was 918 u/mL. Liver biopsy revealed poorly differentiated pancreatic carcinoma, mismatch repair (MMR) proficient, without BRCA1/2 mutations. Surprisingly, tumor mutation testing using next-generation-sequencing (NGS) panel discovered wildtype KRAS and pathogenic BRAF c.1799T>A (V600E) mutation. The patient received a single cycle of Oxaliplatin-based chemotherapy and decided not to pursue additional cycles due to poor tolerability. The case was presented at a multidisciplinary tumor board (MTB) and combination targeted therapy using Dabrafenib and Trametinib was suggested. The patient was given full dose therapy with Dabrafenib 150 mg twice daily with Trametinib 2 mg once a day. During treatment the patient had no apparent side effects. CA19-9 declined within a week from 2,774 to 1,687 u/mL. After 19 days on treatment schedule, the patient has arrived to the Emergency Department with severe abdominal pain. CT showed intra-peritoneal free air without obvious anatomic pathology involving the intestines. Disease extent evaluation was difficult due to lack of oral and intravenous contrast media. Sadly, the patient refused to undergo exploratory surgery and deceased within several hours.