Large Aortic Necrotizing Granuloma: A Rare Manifestation of Mycobacterial Infection

We report a rare case of an 80-year-old man with an ascending aortic mass that was found to be a necrotizing granuloma secondary to disseminated atypical mycobacteria. He presented with a 3to 4-week history of fevers, aches, nights sweats, and a 10-pound weight loss. Computed tomography of the chest showed an ascending aortic mass (Fig 1, red arrow). Intraoperative transesophageal echocardiography showed a large freely mobile pedunculated mass on the anterior surface of the aorta close to the sinotubular junction (Fig 2, blue arrow). The patient underwent successful aortic mass excision. A 3 3 cm friable pedunculated mass on the anterior surface of the aorta with a stalk about 4 mm thick attached to the sinotubular junction was excised (Fig 3). In addition to the aortic mass, the patient was also found