Cutaneous Metastases as the Initial Manifestation of Pancreatic Adenocarcinoma: Case Report and Literature Review

Introduction: Cutaneous metastases from pancreatic adenocarcinoma are rare, particularly when they present as the initial manifestation of the disease. Their appearance is generally associated with advanced disease and poor prognosis. Case Presentation: We report the case of a 77-year-old male who presented with asthenia, unintentional weight loss, and asymptomatic violaceous macules located on the inguinal and abdominal regions. A skin biopsy revealed poorly differentiated adenocarcinoma metastases. Imaging studies subsequently identified a primary tumor in the pancreas, confirming the diagnosis of metastatic pancreatic adenocarcinoma. Conclusion: This case highlights the importance of considering internal malignancies in the differential diagnosis of new-onset cutaneous lesions, particularly in elderly patients with systemic symptoms. Early recognition of atypical cutaneous metastases can facilitate prompt diagnosis and management of underlying malignancies, even those as aggressive as pancreatic cancer.