Case report: marantic endocarditis in renal cell carcinoma: nephrectomy a treatment

Background Marantic endocarditis (non-bacterial thrombotic endocarditis) is a rare condition that involves non-infectious thrombotic lesions typically of the aortic and mitral valves. It is predominantly associated with malignancy and less commonly systemic lupus erythematosus. In this case, we repo...

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Bibliographic Details
Published in:European heart journal : case reports 2021-11, Vol.5 (11), p.ytab437
Main Authors: Harris, Andrew Z, Ternouth, Ian, Lallu, Bhavesh D
Format: Article
Language:English
Subjects:
Cancer
Carcinoma, Renal cell
Care and treatment
Case Report
CT imaging
Drug therapy
Endocarditis
Lupus
Systemic lupus erythematosus
Type 2 diabetes
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Summary:Background Marantic endocarditis (non-bacterial thrombotic endocarditis) is a rare condition that involves non-infectious thrombotic lesions typically of the aortic and mitral valves. It is predominantly associated with malignancy and less commonly systemic lupus erythematosus. In this case, we report a patient with marantic endocarditis secondary to a renal cell carcinoma that was successfully treated with nephrectomy and anticoagulation. Case summary A 65-year-old male patient with embolic signs and symptoms was found to have non-infective thrombotic vegetations on three cardiac valves through transoesophageal echocardiography. Computed tomography revealed a 70 mm renal mass that confirmed to be a grade two clear-cell renal cell carcinoma. Nephrectomy and anticoagulation led to resolution of the embolic symptoms and of the valvular vegetations. Discussion The diagnosis of marantic endocarditis requires high clinical suspicion in a patient who presents with features of embolization. Incidence is highest in patients with an underlying malignancy, particularly adenocarcinoma. This case highlights the importance of echocardiography in diagnosis, removal of the source of thrombus, and prompt treatment with anticoagulation.
ISSN:2514-2119
2514-2119
DOI:10.1093/ehjcr/ytab437