Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm

Arash Aryana, Dennis J. Esterbrooks, Peter C. Morris

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


We describe the case of a 43-year-old woman with transient ischemic neurologic deficits and recurrent systemic and pulmonary emboli in whom infectious work-up and extensive thrombophilic evaluation were unremarkable. Transesophageal echocardiography (TEE) established the diagnosis of nonbacterial thrombotic endocarditis (NBTE). This is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas, characterized by cardiac vegetations along valvular coaptation lines without destruction of leaflets. In our patient, we diagnosed an ovarian clear cell adenocarcinoma, a malignant disorder that has been rarely reported in association with NBTE. This case illustrates that NBTE can present as an atypical manifestation of malignancy and must be distinguished from infective endocarditis, which implies a different therapeutic strategy. When confronted with findings of NBTE without a clear etiology, an occult neoplasm must be excluded. Anticoagulant therapy is the mainstay of treatment. However, cardiac vegetations may require surgical intervention in rare instances.

Original languageEnglish (US)
Pages (from-to)C12-C15
JournalJournal of General Internal Medicine
Issue number12
StatePublished - Dec 2006

All Science Journal Classification (ASJC) codes

  • Internal Medicine


Dive into the research topics of 'Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm'. Together they form a unique fingerprint.

Cite this