While two reports describe clear cell sarcoma presenting as a second malignant neoplasm following prior therapy for acute leukemia [4, 13], one appears histologically to be more in keeping with conventional CCS [13], while the other is reported as harboring a t(12;22) translocation in keeping with EWSR1-ATF1 rearrangement [4]. The gene discussed is ATF1; the disease is acute leukemia.