A mobile thrombus in an otherwise normal ascending aorta is rare, but it should be thoroughly searched for in patients with unexplained cerebral or peripheral embolism. We report the case of a 49-year-old man admitted for right lower quadrant abdominal pain secondary to embolic renal infarction. Echocardiography and computed tomography of the chest revealed a 2.5 cm × 1.5 cm hypermobile mass at the distal ascending aorta, which was otherwise normal. No hypercoagulable condition could be identified. The mass was successfully removed with the patient under deep hypothermic circulatory arrest and was confirmed to be a thrombus. The cause of this thrombus remains unknown.
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