Pancreatic cancer unveiled by multisystemic manifestations

Pancreatic cancer is characterised by its aggressive progression, late-stage diagnosis and poor prognosis. This case report illustrates the intricate interplay between pancreatic adenocarcinoma, disseminated intravascular coagulation with diffuse alveolar haemorrhage and bone metastasis in an elderly woman. Presenting with asthenia, significant hip pain and haemoptysis, her work-up revealed multiple supradiaphragmatic adenopathies and infradiaphragmatic adenopathies, pancreatic parenchymal heterogeneity and lytic bone lesions. Despite extensive diagnostic efforts, a diagnosis of adenocarcinoma of probable pancreatobiliary origin was established only at an advanced stage, leading to a fatal outcome within a week. The patient experienced rapid clinical deterioration, characterised by refractory respiratory failure, haematological dysfunction and circulatory shock, highlighting the aggressive course of pancreatic cancer and its complications. This case underscores the diagnostic challenges and the critical need for early recognition and tailored strategies in managing complex presentations of pancreatic cancer, especially with rare and severe systemic manifestations.