In the presented case of a 60-year-old man, deep vein thrombosis and pulmonary embolism symptoms preceded pancreatic cancer diagnosis. An unexpected echocardiographic finding was a longitudinal mass attached to the tricuspid valve, and extending to the pulmonary artery - suggestive of a thrombus (as confirmed further autopsy), probably embolic in origin. This uncommon situation might be due to nonbacterial thrombotic endocarditis, which involved all, but mainly tricuspid and aortic valves. During heparin therapy the patient's haemodynamic status was stable until systemic emboli occurred with multifocal ischaemic stroke that was the cause of death.
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