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CASE REPORT article

Front. Cardiovasc. Med.

Sec. Cardiovascular Imaging

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1660722

This article is part of the Research TopicCardiovascular Imaging Case Reports 2025: Emphasizing Uncommon Clinical ScenariosView all 7 articles

Hidden in Motion: A Challenging Aortic Mass Unveiled by 3D Transesophageal Echocardiography

Provisionally accepted
Mattia MalagutiMattia Malaguti1*Luigi GerraLuigi Gerra2Leonardo FontanesiLeonardo Fontanesi3Andrea BarbieriAndrea Barbieri4Giuseppe BorianiGiuseppe Boriani4Francesca MantovaniFrancesca Mantovani5
  • 1Local Health Unit of Modena, Modena, Italy
  • 2Ospedale Guglielmo da Saliceto, Piacenza, Italy
  • 3Hesperia Hospital, Modena, Italy
  • 4Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • 5Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy

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This case report describes a 76-year-old asymptomatic male with a highly mobile, elongated, and filamentous structure incidentally detected in the ascending aorta during routine echocardiographic evaluation. The nature of this mass was initially unclear, as its appearance and behavior did not fit the typical features of thrombi, atheroma, vegetations, or dissection. Given the high risk of systemic embolization, timely intervention was deemed necessary. Advanced multimodality imaging, particularly three-dimensional transesophageal echocardiography (3D-TEE), played a pivotal role in defining the lesion's characteristics. Surgical removal was performed, and histopathological analysis provided an unexpected final diagnosis. This case underscores the value of 3D-TEE in assessing rare aortic abnormalities that may not be fully characterized using conventional imaging techniques.

Keywords: Aortic plaque, Atheroma, Incidental finding, 3D transesophageal echocardiography, multimodality imaging

Received: 06 Jul 2025; Accepted: 08 Aug 2025.

Copyright: © 2025 Malaguti, Gerra, Fontanesi, Barbieri, Boriani and Mantovani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mattia Malaguti, Local Health Unit of Modena, Modena, Italy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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