Nonbacterial thrombotic (marantic) endocarditis is most commonly associated with which type of cancers?

Nonbacterial thrombotic endocarditis, also known as marantic endocarditis, is a condition characterized by the presence of sterile vegetations on heart valves, most commonly the mitral and aortic valves. This condition is typically associated with advanced malignancies, particularly adenocarcinomas.

Adenocarcinomas, especially pancreatic cancer, are strongly linked to nonbacterial thrombotic endocarditis due to the hypercoagulable state induced by these tumors. The cancer releases pro-inflammatory cytokines and other substances that promote coagulation, leading to the formation of the small vegetations seen in this condition, which are not infected by bacteria.

While other cancers can potentially be associated with this endocarditis, adenocarcinomas are the most prevalent, with pancreatic cancer being a classic example in the literature. This association helps in understanding the underlying pathophysiology and provides insights into the management of patients with malignancies who may present with cardiac manifestations.