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Sanioglu S et al. - The authors report a case of a 64-year-old man who was referred to the emergency unit because of suspected type A aortic dissection. Computerized tomographic and transthoracic echocardiographic scans revealed a floating thrombus in the aneurysmatic ascending aorta. The thrombus was removed with the dilated aorta. Although the aortic wall was macroscopically normal, histologic examination revealed metastatic papillary adenocarcinoma.

Exclusive Author Commentary
Soner Sanioglu, 05/23/09

Floating thrombus in the ascending aorta is rare and the main causings are generalized hypercoagulation, vascular endothelial disorders, or catheter-induced injuries. The present report suggests that metastatic invasion of the aorta can lead to intraluminal thrombotic mass, and occult malignacy should be suspected and investigated on such cases.

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