Intra-aortic metastases or intra-arterial thrombus?

Introduction: Intra-arterial malignancies are difficult to diagnose as they mimic other more common pathologies such as pulmonary embolus and vascular occlusive disease. Appropriate treatment may, therefore, be delayed.
Case Report: We report a case of an occluded carotid artery and aortic mucosal thickening with a peduculated thrombus occurring in a patient with metastatic sarcomatoid carcinoma while anticoagulated.
Conclusion: Diagnosis requires various imaging modalities and a consideration of an alternative diagnosis if not responding to initial therapy.