Trousseau Syndrome Caused by Ovarian Cancer and Nonbacterial Thrombotic Endocarditis in Aortic Valves

(Department of Cardiovascular Surgery, Saga Prefectural Hospital Koseikan, Saga, Japan)

Hisashi Sato Hitoshi Ohteki Kozo Naito
Junji Yunoki
A 45-year-old woman was admitted for acute left hemiplegia and left hypogastric pain. Central CT showed a right parietal lobe infarction. Abdominal CT demonstrated ovarian tumor and infarction of the liver, spleen and kidney. Chest radiography showed moderate cardiomegaly. Transthoracic echocardiography demonstrated vegetation in the aortic valves and severe aortic regurgitation. Aortic valve replacement and bi-adnexectomy were performed urgently. Intraoperative examination revealed normal aortic valves except for small amounts of vegetation on leaflet surfaces. Pathological diagnosis of vegetation was fibrin without inflammatory cells or bacteria. The postoperative course was uneventful, and the patient was discharged 13 days after surgery without a permanent neurological deficit. Trousseau syndrome caused by ovarian cancer and nonbacterial thrombotic endocarditis is rare, and it is important to be aware of this syndrome in the case of a young cerebral infarction patient with malignant disease.
@Jpn. J. Cardiovasc. Surg. 35: 102-105 (2006)