A floating thrombus detected by CT in the descending aorta in an obese patient: A possible genetic-environmental interaction

• Main Authors: Barbara Brogna, MD, Maria Amitrano, MD, Sara Mangiacapra, MD, Enzo Gravino, MD, Pietro Maurizio Fabio Capasso, MD, Giuliano Gagliardi, MD, Lanfranco Aquilino Musto, MD
• Format: Article
• Language: English
• Published: Elsevier 2021-02-01
• Series: Radiology Case Reports
• Subjects: Floating aortic thrombus; Computed tomography angiography; Obesity
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320306178
• ISSN: 1930-0433

A floating thrombus in a nonaneurysmal, nonatherosclerotic aorta is a rare finding and may represent an unusual source of systemic embolism. Less than 130 cases have been reported in the literature. We describe a rare case of aortic floating thrombus in the descending aorta and the proximal portion of the suprarenal abdominal aorta detected by computed tomography angiography in a 50-year-old woman who was admitted to our emergency room with epigastric abdominal pain. The computed tomography angiography also showed some defects in the subsegmentary pulmonary artery branches along with a splenic infarction with splenic artery and vein thrombi, and a left renal thrombus. On genetic testing the patient resulted heterozygous for the polymorphism for 5,10‐methylentetrahydrofolate reductase C677T polymorphism and also with homozygous deletion alleles of the angiotensin-converting enzyme gene. The aortic floating thrombus resolved during anticoagulant therapy after 4 weeks.