The Cryptic Entity of Marantic Endocarditis. A Tale of Multiple Ischemic Strokes In Metastatic Pancreatic Adenocarcinoma

The Cryptic Entity of Marantic Endocarditis. A Tale of Multiple Ischemic Strokes In Metastatic Pancreatic Adenocarcinoma

Non-bacterial thrombotic endocarditis (NTBE), termed marantic endocarditis, is a rare and non-infectious form of endocarditis that can be caused by autoimmune diseases, particularly antiphospholipid syndrome, and malignant neoplasms of pancreas, stomach and the lungs. It leads to frequent embolization owing to a complex pathogenesis. It is often diagnosed post-mortem with an overall incidence of 1% according to previous autopsy series, most commonly affecting patients between the fourth and eighth decades of life with no sex predilection. We present a case of metastatic pancreatic adenocarcinoma with recurrent ischemic strokes and an eventual co-diagnosis of NTBE culminating in a fatal outcome.