A 33 year old man presented with a short history of slight fever and chest pain that was worse on inspiration. An electrocardiogram was consistent with pericarditis. Chest radiography, echocardiography, and computed tomography suggested the presence of a mediastinal tumour. At operation the mass was found to be attached to the right sinus of Valsalva and proved to be a large saccular aneurysm full of laminated thrombus.
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