A Rare Case of Ovarian Tumor Presenting as Cerebral Embolism from Nonbacterial Thrombotic Endocarditis with Giant Vegetation

Li Z1#, Dai T2#, Yang Y1, Lujia Ni2* and Daoyuan Si1*

1Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function, China
2Department of Ultrasound, China-Japan Union Hospital of Jilin University, China
#These authors contributed equally to this work

^*Correspondance to: Lujia Ni 

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Abstract:

Background: Nonbacterial Thrombotic Endocarditis (NBTE) is a rare condition characterized with non-infection vegetation on cardiac valves which usually leads to systematic embolism. Large vegetations are rare, however, we report a case of NBTE with giant vegetations, resulting in multiple organ embolism in brain, lung and lower limb arteries. Further examination revealed an ovarian tumor. Case Report: A 54-year-old female was referred to our hospital with multiple cerebral infarctions. Of note, she had bilateral lower extremity deep vein thrombosis and bilateral pulmonary arterial branches embolism 3 months ago. Therefore, she is currently on anticoagulant therapy. Subsequent transthoracic echocardiograms demonstrated giant vegetations on anterior and posterior mitral leaflet. Serial blood cultures and procalcitonin remained negative raising suspicion for nonbacterial thrombotic endocarditis. Further examination of an unexpected ovarian tumor confirmed this diagnosis. Conclusion: This current report demonstrates that the possibility of NBTE should be considered especially in a patient suffering from vegetation on cardiac valves presenting with the embolic phenomenon, and further causes should be actively sought such as malignancy, autoimmune disease and so on. Strive for early diagnosis and treatment to improve the survival rate of these patients.

Keywords:

Nonbacterial thrombotic endocarditis; Cancer-associated thrombosis; Stroke; Case report

Cite the Article:

Li Z, Dai T, Yang Y, Lujia Ni, Daoyuan Si. A Rare Case of Ovarian Tumor Presenting as Cerebral Embolism from Nonbacterial Thrombotic Endocarditis with Giant Vegetation. Ann Clin Case Rep. 2023; 8: 2435..