Abstract
Pancreatic signet ring cell carcinoma (PSRCC) is a rare and aggressive subtype of pancreatic cancer with a dismal prognosis. We present the case of a 50-year-old male who, within six weeks, developed a pancreatic mass with liver metastases. Endoscopic ultrasound-guided biopsy confirmed PSRCC. The presentation of this tumour with distant metastasis after a negative computed tomography (CT) of the abdomen and pelvis six weeks prior underscores the highly aggressive nature of PSRCC and the crucial need for heightened clinical suspicion, especially in cases with persistent or atypical abdominal pain. This case highlights the limitations of current diagnostic modalities and emphasises the urgent need for further research into improved early detection methods, molecular characterisation and effective treatment strategies for this rare and lethal subtype of pancreatic cancer. LEARNING POINTS: Aggressive malignancy can become metastatic within six weeks of a negative CT scan.A CT scan may not detect a small pancreatic lesion <2 cm.