A growing number of investigations has recently called attention to patients with myocardial infarction (MI) and non-obstructive coronary arteries (MINOCA) [1], who constitute an intriguing subgroup with peculiar presenting features and prognosis [2-4]. Due to the limited burden of atherosclerosis, several alternative mechanisms have been implicated in the pathogenesis of the condition, including spasm, dissection, microvascular dysfunction and thrombophilic states. Recently, preliminary observations have suggested that malignancy is common in patients with MINOCA [5], and might be associated with a worse outcome [6,7].