{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T06:10:12Z","timestamp":1756447812466,"version":"3.44.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1660722","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T05:44:21Z","timestamp":1756446261000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Hidden in motion: a challenging aortic mass unveiled by 3D transesophageal echocardiography"],"prefix":"10.3389","volume":"12","author":[{"given":"Mattia","family":"Malaguti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Gerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Fontanesi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Barbieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Mantovani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1053\/j.sult.2011.10.001","article-title":"Aortic tumors","volume":"33","author":"Restrepo","year":"2012","journal-title":"Semin Ultrasound CT MRI"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1093\/ehjci\/jead024","article-title":"Multimodality imaging in thoracic aortic diseases: a clinical consensus statement from the European Association of Cardiovascular Imaging and the European Society of Cardiology working group on aorta and peripheral vascular diseases","volume":"24","author":"Evangelista","year":"2023","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2015.09.011","article-title":"Guidelines for the use of echocardiography in the evaluation of a cardiac source of embolism","volume":"29","author":"Saric","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1197.e5","DOI":"10.1016\/j.echo.2009.04.017","article-title":"A hanging mass in the ascending aorta diagnosed by transthoracic echocardiography in a totally asymptomatic subject","volume":"22","author":"Baldini","year":"2009","journal-title":"J Am Soc Echocardiogr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1016\/j.jaccas.2021.07.027","article-title":"Incidentally found ascending aortic thrombus","volume":"3","author":"Quach","year":"2021","journal-title":"JACC Case Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1016\/j.jaccas.2021.08.002","article-title":"Sudden cardiac arrest due to ascending aortic thrombus originating from penetrating aortic ulcer","volume":"3","author":"Stern","year":"2021","journal-title":"JACC Case Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"2023 ESC guidelines for the management of endocarditis","volume":"44","author":"Delgado","year":"2023","journal-title":"Eur Heart J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e24","DOI":"10.1056\/ENEJMicm010900","article-title":"Giant lambl\u2019s excrescences","volume":"349","author":"Aggarwal","year":"2003","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/5134309","article-title":"A large grade 5 mobile aortic arch atheromatous plaque: cause of cerebrovascular accident","volume":"2018","author":"Alvarez","year":"2018","journal-title":"Case Rep Med"},{"key":"B10","first-page":"797","article-title":"Very large, pedunculated and mobile plaques in ascending thoracic aorta","volume":"8","author":"Roa","year":"2021","journal-title":"Int J Clin Med Imaging"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1016\/j.jcmg.2018.03.023","article-title":"Thoracic aortic calcification","volume":"11","author":"Desai","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1002\/ccr3.2164","article-title":"Syncope in a female patient. 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