CTICasesFloating Aortic Thrombus
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Imaging findings
Contrast-enhanced CT of a patient with metastatic ovarian cancer and carcinomatosis reveals a large malignant pleural effusion and a well-defined, non-calcified, pedunculated filling defect attached to the wall of the proximal descending thoracic aorta, behaving as a floating thrombus in an aorta that is otherwise free of significant atherosclerotic plaque.
Key takeaways
Floating or pedunculated aortic thrombi are rare and can occur in patients without significant pre-existing aortic atherosclerosis. These lesions are frequently associated with underlying hypercoagulable states, such as active malignancy, and carry a high risk of systemic embolization, sometimes requiring anticoagulation or surgical resection.
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