Nonbacterial Thrombotic Endocarditis in Pancreatic Cancer Endocardite trombotica non batterica in associazione con una neoplasia pancreatica

Nonbacterial Thrombotic Endocarditis in Pancreatic Cancer. B. Piovanelli, R. Rovetta, I. Bonadei, E. Vizzardi, A. D'Aloia, M. Metra. Nonbacterial thrombotic endocarditis (NBTE), known as marantic endocarditis, is a phenomenon due to hyperco- agulability with a complex pathogenesis. Originally de- scribed by Ziegler, the lesions of NBTE were considered to be fibrin thrombi deposited on normal or superficially de- generated cardiac valves (1). Numerous reports have identi- fied the relationship between NBTE and a variety of differ- ent inflammatory states, including chronic diseases like ma- lignancy and autoimmune disease (2, 3). NBTE is a serious manifestation of prothtombotic state that is characterized by the deposition of thrombi on previously undamaged heart valves in the absence of a bloodstream bacterial infection and by the increased frequency of arterial embolic events in pa- tients with chronic debilitating diseases. Although hyperco- agulability is often seen in patients with pancreatic cancer, NBTE has rarely been reported antemortem. We report a case of marantic endocarditis in patient with pancreatic can- cer, in which neurological symptoms preceded the diagnosis of pancreatic cancer.