Mobile mural thrombus and spontaneous echo contrast in ascending aorta after postoperative adjuvant cisplatin-based chemotherapy

A 70-year-old asymptomatic male who had undergone a right nephrectomy for renal pelvic cancer was referred to us with a thrombus in the ascending aorta detected by contrast-enhanced computed tomography after chemotherapy with gemcitabine/cisplatin. Transesophageal echocardiography revealed a 4-cm mobile mural thrombus in the ascending aorta. An emergency thoracotomy for planned aortic root replacement was performed, but the intraoperative epi-aortic ultrasound indicated that the thrombus had disappeared, and it showed prominent spontaneous-echo contrast (SEC) in the ascending aorta. We speculate that vascular endothelium damage due to the cisplatin-based chemotherapy induced the thrombus and SEC in the ascending aorta.