Inflammatory myofibroblastic tumors (IMT) are rare, mostly benign soft tissue tumors. Occurring mainly in children the presentation, clinical features, and diagnostic dilemmas raised are well reported. Here we describe 4 patients diagnosed with IMT after the treatment of childhood cancer, and review the literature regarding IMT and malignancy. Discussing them in this context raises clinical questions; Are these tumors incidental or a consequence of treatment? Are they more common than we think and are any miss-diagnosed as tumor recurrence? This paper aims to raise awareness of IMT as diagnostic possibilities after treatment for childhood malignancies.