A Case Series Of Non-Bacterial Thrombotic Endocarditis Associated With Gynecological Malignancies (P6.248)
Bibliographic record
Abstract
Objective: To describe three patients presenting with ischemic strokes secondary to non-bacterial thrombotic endocarditis (NBTE) associated with gynecological malignancies. Background: Ischemic stroke secondary to NBTE is a rare complication of systemic malignancies. These strokes are most commonly associated with adenocarcinomas, in particular lung and gastro-intestinal, and lymphoma. Although previously reported in gynecological cancers, this occurrence is infrequent. Furthermore, stroke pre-dating the gynecological malignancy diagnosis has rarely been reported. Design/Methods: Case presentations and literature review. Results: Case1: A 48-year-old woman presented with acute dysarthria and left facial weakness. A Computerized Tomography (CT) head scan showed a right middle cerebral artery (MCA)infarct. Mitral valve vegetations were found on a transthoracic echocardiogram (TTE). A malignancy screen uncovered a large pelvic mass that was subsequently characterized as grade III endometrial adenocarcinoma. Case 2: A 49-year-old woman developed acute right hand weakness. A CT head scan showed an infarct in the left pre-central gyrus. Her trans-esophageal echocardiogram (TEE) revealed aortic valve vegetations. An ovarian tumor was discovered on malignancy work-up and later described as a grade III serous neoplasm. Case 3: A 36-year-old woman with a known diagnosis of 1B cervical squamous cell carcinoma developed acute left sided weakness and decreased level of consciousness. A CT head scan showed a large right MCA stroke. Aortic valve vegetations were seen on TTE. Multiple sets of blood cultures were negative in all three cases. Conclusions: NBTE is an important ischemic stroke mechanism. We have reported three cases where the underlying malignancy was gynecological (endometrial, ovarian, and cervical). In the first two cases, the malignancy was discovered during the investigations for the stroke mechanism, while the third had a known underlying malignancy. This series highlights the need to consider gynecological malignancies as an underlying cause of stroke in young women; and that the ischemic event can occur prior to the malignancy diagnosis.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".