A hanging mass in the ascending aorta diagnosed by transthoracic echocardiography in a totally asymptomatic subject.

Aortic mural thrombosis is generally associated with several diseases, including coagulopathies, aortic dissection or trauma, tumors, and complicated atherosclerotic plaques. The development of a friable mobile thrombus, especially in the ascending aorta or proximal aortic arch, is a rare event with potentially ominous consequences because of a life-threatening risk of stroke and peripheral embolization. The treatment of choice of this condition is still controversial. We report a case of an absolutely asymptomatic 57-year-old patient with a mobile, pedunculated mass attached to the posterior wall of an otherwise normal ascending aorta. The aortic mass, identified by transthoracic echocardiography, was surgically removed and demonstrated to be a thrombus, and the aortic wall specimen was microscopically normal.