Ulcerofungating Rectal Mass Caused by Cytomegalovirus Infection in a Patient with AIDS

ABSTRACT

Cytomegalovirus infection is a common complication in patients suffering from advanced acquired immunodeficiency syndrome. Cytomegalovirus infections of the gastrointestinal tract in human immunodeficiency-virus-positive patients tend to manifest as ulcerative lesions rather than as mass lesions. In this study, we describe a case of a mass lesion identified as cytomegalovirus proctitis in a human immunodeficiency-virus-positive patient, which had initially been thought to have an adenocarcinoma or a lymphoma. A 60-year-old man had an ulcerofungating mass in the rectum, which was initially detected via palpation. Findings of computerized tomography indicated a malignant mass, which was enhanced in the contrast image. An additional colonoscopy and biopsy were conducted for purposes of diagnosis. The histological examination revealed characteristic inclusion bodies within the nuclei of vascular endothelial cells in the ulcer bed. Immunohistochemical staining with anti-cytomegalovirus antibody confirmed the diagnosis of cytomegalovirus infection. The patient's anorectal lesion had subsided after the initiation antiviral treatments. The diagnosis of cytomegalovirus infection in human immunodeficiency-virus- positive patients occasionally proves rather difficult. Cytomegalovirus infection had induce the formation of mass lesions in immunocompromised patients.