Rectal polypoid Inflammatory Myofibroblastic Tumor in 39-year-old liver transplant recipient with de-novo ulcerative colitis: A case report and literature review

We describe a rare, polypoid Inflammatory Myofibroblastic Tumor (IMT) and de-novo ulcerative colitis (UC) arising concurrently in the rectum of a 39-year-old liver transplant recipient. This is the third report of an IMT or IPT (Inflammatory Pseudotumor) occurring in a liver transplant recipient, the first in an adult, and only the fifth IMT/IPT to involve the rectum. It is also the first to be identified in an individual with confirmed ulcerative colitis. We discuss the potential role of Tumor Necrosis Factor alpha (TNFα) in the pathogenesis of these rare neoplasms and consider a biological association between IMTs and ulcerative colitis. We also recognize IMTs as a rare, potentially serious complication of solid-organ transplants and discuss the significance of both an autoimmune disease and an IMT developing simultaneously in the setting of potent immunosuppression.