Plantar keratoderma as a presenting sign of pancreatic adenocarcinoma

A 76-year-old woman presented with a 1-year history of back pain and sudden onset of plantar keratoderma. Her serum carbohydrate antigen (CA 19.9) levels were elevated. Endoscopic radial sonographic examination led to the diagnosis of pancreatic adenocarcinoma, in a stage not detectable with helical CT yet amenable to surgical therapy. Cutaneous lesions disappeared after distal pancreatectomy. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008