Post-Transplant Jejunal Mass: Mesh Erosion Masquerading as Tumor-A Case Report

Abdominal masses in solid organ transplant recipients present a diagnostic challenge, as immunosuppression increases the risk of malignancies such as post-transplant lymphoproliferative disorder (PTLD) and gastrointestinal stromal tumors (GISTs). These entities frequently involve the bowel and may manifest with nonspecific or vague abdominal symptoms, making differentiation between benign and malignant small bowel obstruction (SBO) critical for appropriate management and prognosis. We present the case of a kidney transplant recipient on chronic immunosuppression who developed intermittent abdominal pain and nausea, ultimately diagnosed with partial SBO. Cross-sectional imaging revealed a jejunal mass concerning for lymphoma. However, surgical exploration demonstrated jejunal erosion by a previously placed surgical mesh with an associated fecalith, mimicking neoplastic disease. The patient underwent segmental bowel resection with mesh removal, leading to complete resolution of symptoms. This case highlights the importance of maintaining a broad differential diagnosis when evaluating intra-abdominal masses in transplant recipients, particularly in those with a history of prior surgery and mesh placement. Awareness of this potential mimic is essential to avoid misdiagnosis and ensure timely surgical management.