Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 27 11 2024 11 01 Scalp Lesion as the First Manifestation of Pancreatic Adenocarcinoma, A Very Rare Case 639 642 10.34172/aim.31235 EN Luis Posado-Domínguez https://orcid.org/0009-0005-4606-2316 Jonnathan Roldan-Ruiz https://orcid.org/0000-0002-4476-5318 María Martin-Galache Alejandra Ruiz-Villanueva Maria L Perez-García Journal Article 10.34172/aim.31235 2024 04 29 2024 07 01 Pancreatic adenocarcinoma is one of the most aggressive tumors. Its diagnosis is usually made in locally advanced or metastatic disease and survival is less than one year. The most frequent sites of metastatic involvement are the liver, peritoneum and lungs. Other organs such as the bones or the brain may be affected to a lesser extent. Cutaneous involvement of pancreatic adenocarcinoma is extremely rare with less than 150 cases reported in the literature since 1960. Most cases with cutaneous involvement involve the periumbilical region, in a lesion known as "Sister Mary Joseph’s Node". Scalp metastases are very rare and their diagnosis suggests advanced disease and the prognosis will be dismal. It is very important to perform a complete physical examination and a global anamnesis to guide the request for diagnostic tests. Once the diagnosis of pancreatic adenocarcinoma has been made, a global assessment will be necessary, involving different medical specialists, nurses, psychologists and social workers among others. In many cases, supportive care is the mainstay of treatment.