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Cytomegalovirus (CMV) is a highly prevalent pathogen that remains dormant in majority of the cases. Severe CMV infection is generally limited to immunocompromised hosts. While occasional cases of CMV hepatitis are observed in healthy immunocompetent hosts, it is very rare to find this associated with focal liver lesions mimicking malignancy. Cases of non-immunosuppressed CMV reactivation, CMV-associated liver lesions, and CMV-associated portal vein thrombosis have all been reported individually, we present a single case of CMV with all of these rare manifestations.