DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.012

Pages: 916-919

Background: Inflammatory myofibroblastic tumor is a rare mesenchymal neoplasm of intermediate biological potential that most commonly affects the lung and pediatric population. Gastrointestinal involvement is uncommon, particularly in the colon. The association between IMT and inflammatory bowel disease, especially Crohn’s disease, is exceedingly rare and poses significant diagnostic challenges due to overlapping clinical and radiological features. Case Presentation: We report the case of a 38-year-old man presenting with chronic diarrhea, weight loss, and obstructive symptoms. Imaging and colonoscopy revealed a stenosing cecal mass with terminal ileal involvement, initially suggestive of Crohn’s disease or intestinal tuberculosis. Surgical resection was performed, and histopathological examination confirmed an inflammatory myofibroblastic tumor with clear margins. The postoperative course was favorable, with complete symptom resolution. Three years later, the patient developed recurrent diarrhea, and further evaluation revealed chronic active colitis with non-caseating granulomas, leading to a definitive diagnosis of Crohn’s disease. Treatment with azathioprine resulted in sustained clinical and endoscopic remission. Conclusion: This case illustrates a rare and unusual temporal association between colonic IMT and Crohn’s disease, with IMT preceding the diagnosis of inflammatory bowel disease. It underscores the importance of considering rare benign tumors in the differential diagnosis of mass-forming colonic lesions and highlights the need for long-term surveillance in patients with atypical inflammatory presentations. Improved awareness of this rare association may help prevent diagnostic delays and inappropriate therapeutic strategies.