Cytomegalovirus infection masquerading as colonic neoplasia

Cytomegalovirus (CMV) infection in the immunocompromized patient usually represents a reactivation of latent infection and occurs in 60–90% of renal transplant patients after initiation of immunosuppressive therapy (Cho et al, 1981). The range of gastrointestinal presentations is wide but a case with the clinical, radiological and operative features of a colonic neoplasm has not previously been described. A 53-year-old man was referred with an 8 month history of intermittent epigastric pain associated with diarrhoea for the past 2 months. He had not noticed any blood or mucus in the stools. Nine years previously he had received a cadaveric renal transplant for end stage renal failure secondary to congenital polycystic kidneys. Renal function at presentation was normal on maintenance immunosuppression (Azathioprine 200mg and Prednisolone 6 mg daily). Physical eamination revealed no significant abnormality and full biochemical and haematological investigations were normal.