title: Marantic endocarditis (NBTE) with systemic emboli and paraneoplastic cerebellar degeneration: uncommon presentation of ovarian cancer.
abstract: We report a case in which the only presenting symptoms of the underlying ovarian malignancy were that of paraneoplastic cerebellar degeneration and nonbacterial thrombotic endocarditis. If suspecting paraneoplastic cerebellar degeneration and nonbacterial thrombotic endocarditis, complete physical examination, including pelvic exams in female patients is warranted. Investigations should include CT chest/abdominal/pelvis, MRI brain, and Transesophageal Echocardiogram. Early recognition will lead to early diagnosis of occult malignancy and initiation of appropriate therapy. Awareness of these complications as initial presentation for internists, gynecologists and neurologists may avoid diagnostic delay.
authors.affiliation: Department of Internal Medicine/Hematology-Oncology, Evanston Northwestern Healthcare, 2650 Ridge Ave, Evanston, IL 60201, USA.
authors.forename: Veerpal
authors.initials: V
authors.lastname: Singh
authors.forename: Ishfaq
authors.initials: I
authors.lastname: Bhat
authors.forename: Kathleen
authors.initials: K
authors.lastname: Havlin
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D020362:Paraneoplastic Cerebellar Degeneration / Q000209:etiology*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed