Pediatric cases demonstrating VCL–ALK and TPM3–ALK fusions exhibited morphologic similarities to adult renal medullary carcinoma and collecting duct carcinoma, such as diffuse solid or reticular/syncytial/tubular growth, with a background of prominent and delicate vascular network, often admixed with significant lymphoplasmacytic inflammatory infiltrate and stromal desmoplasia [19,20,21,27,28]. Here, ALK is linked to kidney medullary carcinoma.