The pathogenesis of nonbacterial thrombotic endocarditis (NBTE) often involves a hypercoagulable state which is the result of the procoagulant effects of circulating products of cancers the resulting cardiac valve vegetations may also be called marantic endocarditis. The pathophysiology of NBTE is similar to that of Trousseau's syndrome (migratory thrombophlebitis) which may also be induced by disseminated cancers like mucinous adenocarcinoma of the pancreas and adenocarcinoma of the lung which may relate to procoagulant effects of circulating mucin. Cancer metastases to the hea usually involve the pericardium or myocardium. Valve metastases are less frequent and would probably have shown invasive characteristics on histological examination.