Key result
High-grade serous ovarian carcinoma presents as non-bacterial thrombotic endocarditis complicated by systemic infarcts.
Why the study?
Non-bacterial thrombotic endocarditis is frequently underdiagnosed and often only identified postmortem, with early diagnosis and anticoagulation potentially reducing mortality.
Case Report (n=1)
This case highlights the diagnostic challenge of non-bacterial thrombotic endocarditis as a presentation of underlying malignancy, emphasizing the importance of echocardiography and systemic evaluation in hypercoagulable states.
NBTE may signal occult ovarian carcinoma; this case leaves open optimal malignancy evaluation in hypercoagulable states.
Non-bacterial thrombotic endocarditis (NBTE) is characterised by sterile vegetations on heart valves and often emerges in hypercoagulable states like malignancy. It is frequently underdiagnosed and only comes to light during postmortem examination. Early diagnosis and treatment with anticoagulation can help lower mortality. We present a case of a woman in her 60s with marantic endocarditis, secondary to ovarian malignancy. She presented with a 4 week history of headache, confusion and abdominal discomfort. Examination revealed cyanosis, splinter haemorrhages and abdominal tenderness. Echocardiogram showed impaired left ventricular function and suspicion of a small vegetation at the tip of the anterior mitral valve. Further investigation revealed multiple cerebellar infarcts, pulmonary embolism, splenic infarct, ascites and a pelvic mass. A biopsy of the pelvic mass and analysis of ascitic fluid was consistent with high-grade serous carcinoma of tubo-ovarian origin. Following discussion at the gynaecology multidisciplinary team meeting, she was scheduled for chemotherapy treatment.
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Altaher et al. (2025) conducted a case report in Non-bacterial thrombotic endocarditis and high-grade serous ovarian carcinoma (n=1). High-grade serous ovarian carcinoma was evaluated. High-grade serous ovarian carcinoma in a woman in her 60s presented as non-bacterial thrombotic endocarditis complicated by multiple systemic infarcts.
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