Neoplastic non-bacterial endocarditis of the aortic valve

<span class="paragraphSection">A 64-year-old man presented with left hemiplegia. Brain magnetic resonance imaging showed multifocal acute infarctions involving the temporal and occipital lobes, thalami, and cerebellum. Blood pressure was 173/64 mmHg and body temperature was normal. There was no microbial yield. Transesophageal echocardiography showed broad-based fuzz-like vegetation attached to the left coronary cusp of aortic valve (AV) (<span style="font-style:italic;">A</span> and <span style="font-style:italic;">B,</span> arrow). Valvular closure was incomplete and severe aortic regurgitation developed along the coaptation surface, particularly around the left coronary cusp (<span style="font-style:italic;">C</span>). Aortic valve replacement surgery was performed to prevent further embolism. </span>

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