CTICasesMobile Aortic Arch Thrombus and Distal Aortic Occlusion Associated with Pancreatic Cancer
Imaging findings
Contrast-enhanced CT reveals large, lobulated, mobile filling defects within the aortic arch consistent with thrombi. More distally, there is complete occlusion of the abdominal aorta by thrombus, along with associated infarcts of the spleen and kidneys. Additionally, a large mass-like area of necrosis is noted in the pancreatic tail.
Key takeaways
Mobile thrombi in the non-aneurysmal, non-atherosclerotic thoracic aorta are rare and pose a high risk of catastrophic systemic embolization. This condition is strongly associated with hypercoagulable states, such as Trousseau's syndrome of malignancy, secondary to underlying cancers like pancreatic tail adenocarcinoma. Anticoagulation is the primary medical management, though surgical or endovascular removal is sometimes indicated.
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