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Prior to initiation of cycle 8, the patient was found to have a pancreatic body mass that was not present on prior radiographic imaging, confirmed by endoscopic ultrasonography and biopsy to be pancreatic adenocarcinoma. CA19-9 was 10000 U/mL, suggesting a primary pancreaticobiliary origin. CONCLUSION Esophageal metastasis diagnosed before primary pancreatic adenocarcinoma is rare. This case highlights the profound metastatic potential of pancreatic adenocarcinoma. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc.