Advanced ovarian carcinoma presenting with a cerebrovascular accident

Ovarian carcinoma usually presents in an indolent manner, most often nonspecifically with complaints of abdominal pain or swelling, bloating, constipation, anorexia, early satiety, and evidence of ascites. We present a case of ovarian cancer with a cerebrovascular accident (CVA) as the presenting symptom, with minimal classic presenting signs and symptoms. The patient is a 43-year-old female with no cardiovascular risk factors who presented with a left parietal lobe infarct and advanced ovarian carcinoma. The patient underwent an extensive workup for the etiology of her CVA and possible hypercoagulation syndrome and eventually had surgical treatment. Ovarian carcinoma with a thromboembolic event as the initial presenting symptom is extremely rare. Although this patient did not appear to have hypercoagulability, consideration of this diagnosis should be given to patients presenting in this manner.