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As multiple blood cultures were sterile and patient lacked clinical signs of infection, an underlying malignancy was suspected. CT abdomen demonstrated a dilated pancreatic duct, MRI showed a 2.8\u00d72.2\u2009cm pancreatic head mass. Endoscopic biopsy of the mass revealed pancreatic adenocarcinoma. Other than NBTE, there were no other clinical or laboratory findings to clearly suggest pancreatic cancer. Thus, incidental discovery of this mitral valve vegetation led to the diagnosis of pancreatic malignancy.<\/jats:p>","DOI":"10.1136\/bcr-2018-224529","type":"journal-article","created":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T13:20:03Z","timestamp":1528809603000},"page":"bcr-2018-224529","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Marantic endocarditis: incidental infarcts leading to diagnosis of pancreatic cancer"],"prefix":"10.1136","volume":"2018","author":[{"given":"Ella","family":"Starobinska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Brucks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Scott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,12]]},"reference":[{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1159\/000207195","article-title":"Marantic endocarditis associated with pancreatic cancer: a case series","volume":"3","author":"Jameson","year":"2009","journal-title":"Case Rep Gastroenterol"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.2","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1001\/jamaoncol.2016.0585","article-title":"Evaluation of pancreatic cancer clinical trials and benchmarks for clinically meaningful future trials: a systematic review","volume":"2","author":"Rahib","year":"2016","journal-title":"JAMA Oncol"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.3","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(87)90719-8"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.9148"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01753.x"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.7","first-page":"399","article-title":"Uber den bau die entstehung endocaritischer efflorescenzen","volume":"7","author":"Zeigler","year":"1888","journal-title":"Werh Dtsch Kong Intern Med"},{"key":"2025042703524546000_2018.jun11_2.bcr-2018-224529.8","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1001\/archinte.1936.00170140045004","article-title":"Nonbacterial thrombotic endocarditis. 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