Stroke as a first manifestation of ovarian cancer

Gynaecologic neoplasms are reported to have the highest potential for developing of ischemic stroke.

The history of a female patient, in whom recurrent cerebral embolism was the first clinical sign of occult ovarian neoplasm is described and the casuistic literature to characterise this clinical phenomenon reviewed.

Among a large spectrum of neoplasms complicating with ischemic stroke, ovarian carcinoma is one of the most frequently reported in the casuistic literature. The source of systemic microembolisation is endocardits of non-infectious origin; the characteristic diagnostic findings are thrombocytopenia, elevated D-dimers level, and a specific stroke pattern in magnetic resonance imaging.

Meticulous diagnosis in female, otherwise 'healthy' patients with ischemic stroke, to detect the underlying neoplastic disease is of paramount importance, as early surgical intervention on cancer promises successful therapy for both, cancer and thromboembolism.