Nonetheless, it is possibly risky to diagnose EIMS rely solely on the histology or ALK expression, because not all IMTs with epithelioid/round cell morphology carry the genetic alteration of EIMS [5], as well as ALK cytoplasmic staining could be encountered in a few mesenchymal tumors, such as rhabdomyosarcoma, malignant peripheral nerve sheath tumor, leiomyosarcoma, lipogenic tumors, and Ewing sarcoma/ peripheral primitive neuroectodermal tumor [20, 21]. This evidence concerns the gene ALK and Ewing sarcoma.