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A 36-year-old man presented after an episode of dizziness and near-fainting. Heart imaging showed a mitral-valve vegetation, while CT of the abdomen and pelvis revealed malignant ascites, omental caking, multiple lytic bone lesions and infarcts in the spleen and kidneys. Biopsy of the omental abnormality showed adenocarcinoma, and stomach biopsy identified undifferentiated gastric adenocarcinoma. The cancer was Stage IV.
He was initially treated with antibiotics for possible infective endocarditis, but repeated blood cultures remained negative and he did not respond as expected. Brain MRI also showed an acute stroke. The overall picture was ultimately diagnosed as nonbacterial thrombotic endocarditis associated with metastatic gastric cancer and a hypercoagulable state.
Antibiotics were stopped and he remained on low-molecular-weight heparin anticoagulation. He was being followed by oncology for chemotherapy.
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer