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We report the case of a 59-year-old man with a giant atherosclerotic thrombus-filled aneurysm of the right coronary artery presenting as an ambiguous spherical mass adjacent to the right atrium at the transthoracic echocardiography study. The diagnosis was established by transesophageal echocardiography, computed tomography, and coronary angiography. Due to extent of the aneurysm, the patient underwent placement of a vein graft to the posterior descending artery and subsequent exclusion of the aneurysm by proximal and distal ligation.