Advertisement

Journal of Neuro-Oncology

, Volume 83, Issue 1, pp 81–83 | Cite as

Marantic endocarditis (NBTE) with systemic emboli and paraneoplastic cerebellar degeneration: uncommon presentation of ovarian cancer

  • Veerpal Singh
  • Ishfaq Bhat
  • Kathleen Havlin
Clinical–Patient Studies

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.

Keywords

Nonbacterial thrombotic endocarditis Paraneoplastic cerebellar degeneration Ovarian cancer Marantic endocarditis Paraneoplastic syndrome 

Abbreviations

PCD

Paraneoplastic cerebellar degeneration

NBTE

Non-bacterial thrombotic endocarditis

ER

Emergency room

MRI

Magnetic resonance imaging

TEE

Transesophageal echocardiogram

CT

Computed tomography

CSF

Cerebrospinal fluid

Reference

  1. 1.
    Henson RA, Urich H (1982) Cancer and the Nervous System. Blackwell Scientific, Oxford, p. 314Google Scholar
  2. 2.
    Closton PD, DeAngelis LM, Posner JB (1992) The spectrum of neurological disease in patients with systemic cancer. Ann Neurol 31:268–273CrossRefGoogle Scholar
  3. 3.
    Walsh PW, Tavee JO, Schuele S et al (2003) Response to intravenous immunoglobulin in Anti-Yo associated paraneoplastic cerebellar degeneration: case report and review of the literature. J Neur-Oncol 63:187–190CrossRefGoogle Scholar
  4. 4.
    Borowski A, Ghodsizad A, Cohnen M et al (2005) Recurrent embolism in the course of marantic endocarditis. Ann Thorac Surg 79:2145–2147PubMedCrossRefGoogle Scholar
  5. 5.
    Ashour AA, Verschraegen CF, Kudelka AP et al (1997) Paraneoplastic syndromes of gynecologic neoplasms. J Clin Oncol 15:1272–1282PubMedGoogle Scholar
  6. 6.
    Bolla L, Palmer RM (1997) Paraneoplastic cerebellar degeneration. Case report and literature review. Arch Intern med 157:1258–1262PubMedCrossRefGoogle Scholar
  7. 7.
    Darnell RB, Posner JB (2003) Paraneoplastic syndromes involving the nervous system. N Engl J Med 349:1543–1554PubMedCrossRefGoogle Scholar
  8. 8.
    Land R, Carter J, Houghton R et al (2005) Gynaecology meets neurology: Paraneoplastic cerebellar degeneration. Aust N Z J Obstet Gynaecol 45:79–81PubMedCrossRefGoogle Scholar
  9. 9.
    Chomette G, Auriol M, Bauboin D et al (1980) Non bacterial thrombotic endocarditis. Autopsy study, clinicopathological correlations. Ann Med Int 131:443–447Google Scholar
  10. 10.
    Kooiker JC, Maclean JM, Sumi SM (1976) Cerebral Embolism, marantic endocarditis, and cancer. Archives of Neurology 33(4):260–264PubMedGoogle Scholar
  11. 11.
    Lopez JA, Ross RS, Fishbein MS et al (1985) Nonbacterial thrombotic endocarditis: a review. Am Heart J 142:629–631Google Scholar
  12. 12.
    Bick RL (2003) Cancer–associated thrombosis. N Engl J Med 349(2):109–111PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Department of Internal Medicine/Hematology–OncologyEvanston Northwestern HealthcareEvanstonUSA

Personalised recommendations