Is virchow's node a rare presentation of pancreatic cancer?

Not common: it happens in some people. When we see someone with a Virchow's node, we start looking for cancer. It can spread to there from many organs, including the pancreas.

Virchow's: node, in the left supraclavicular fossa, is not a common presentation of pancreatic cancer. Pancreatic cancer most commonly presents with weight loss and/or pain. Due to the lymphatic drainage pattern of the abdomen, advanced intra-abdominal cancers, including pancreatic, can involve Virchows node. Lymphomas and other cancers can as well.

Possibly: Virchows node is a node in the left supraclavicular area, it is associated with the lymphatic drainage from the abdomen and can be a site of metastasis form abdominal cancers. It was classically described with gastric cancer but other abdominal malignancies could present this way