Numnum T Michael, Leath Charles A, Straughn Michael J
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, AL, USA.
Obstet Gynecol. 2006 Sep;108(3 Pt 2):748-50. doi: 10.1097/01.AOG.0000190220.13074.87.
Nonbacterial thrombotic endocarditis (NBTE), or marantic endocarditis, is a rare form of endocarditis found in patients with advanced malignancy and collagen-vascular disorders. There is limited information about the clinical course of patients with NBTE because the majority of cases are found at the time of autopsy.
A 38-year-old woman presented to the emergency department with recent onset of chest pain and fatigue. Initial evaluation revealed cardiac valvular disease, and the patient underwent aortic valve replacement. Final pathology revealed nonbacterial thrombotic endocarditis. A metastatic work-up revealed a complex pelvic mass and elevated CA 125. The patient underwent an exploratory laparotomy and was subsequently found to have synchronous primary endometrial and ovarian carcinoma.
Nonbacterial thrombotic endocarditis is rare and carries a high mortality. This case is unusual in that the diagnosis of nonbacterial thrombotic endocarditis led to the diagnosis of a gynecologic malignancy.
非细菌性血栓性心内膜炎（NBTE），又称消耗性心内膜炎，是一种罕见的心内膜炎形式，见于晚期恶性肿瘤和胶原血管疾病患者。由于大多数病例是在尸检时发现的，关于NBTE患者临床病程的信息有限。
一名38岁女性因近期出现胸痛和疲劳就诊于急诊科。初步评估发现心脏瓣膜病，患者接受了主动脉瓣置换术。最终病理显示为非细菌性血栓性心内膜炎。进一步的转移灶检查发现盆腔有一个复杂肿块，CA 125升高。患者接受了剖腹探查术，随后被发现同时患有原发性子宫内膜癌和卵巢癌。
非细菌性血栓性心内膜炎罕见且死亡率高。该病例不同寻常之处在于，非细菌性血栓性心内膜炎的诊断导致了妇科恶性肿瘤的诊断。
