Nonbacterial thrombotic endocarditis as the sole manifestation of stage IV gastric cancer: A case report

Wassim Shatila, Alain Rizkallah, Ehab Saad Aldin, Arafat Tfayli

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction. Nonbacterial thrombotic endocarditis is a very rare complication of malignancy and other hypercoagulable states. It describes the deposition of small sterile smooth or verrucoid vegetations on the valve leaflets, causing a clinical picture similar to that of bacterial endocarditis. The authors reported this case because this is a rare and unusual first manifestation of malignancy generally and of gastric cancer particularly, with only a few reports present in the literature. Case presentation. The authors present a case of a 36-year-old Caucasian male with occult gastric cancer whose first and only manifestation was nonbacterial thrombotic endocarditis causing extensive multi-organ infarctions. Conclusions: An endocarditis not responsive to antibiotics should raise the suspicion of an occult malignancy. Differentiating between an infective endocarditis and a nonbacterial thrombotic endocarditis will cause a radical change in the management which will eventually affect the patient's prognosis.

Original languageEnglish (US)
Article number267
JournalJournal of Medical Case Reports
Issue number1
StatePublished - Aug 4 2014
Externally publishedYes


  • Embolism
  • Endocarditis
  • Nonbacterial
  • Noninfective
  • Stomach neoplasms
  • Thrombosis

ASJC Scopus subject areas

  • Medicine(all)


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