Abstract
Most of the malignant pancreatic lesions are primary pancreatic tumors with only a small percentage due to metastases. Pancreatic malignancies often present with symptoms such as jaundice and weight loss. Less commonly, new-onset diabetes mellitus has been seen in the setting of pancreatic adenocarcinomas. Although colon cancer commonly presents with metastatic disease, it typically spreads to the liver, lung, and peritoneum. We present a rare case of colon cancer metastatic to the pancreas presenting as diabetic ketoacidosis.