The absence of convincing neuroendocrine marker expression is not sufficient for the diagnosis of neuroendocrine carcinomas, and the absence of p40 and CD99 positivity helps rule out Ewing Sarcoma whereas molecular evidence of EWSR1 gene rearrangement aids in the exclusion of adamantinoma like Ewing sarcoma as these can show consistent cytokeratin and p40 expression [10, 11, 17]. This evidence concerns the gene EWSR1 and neuroendocrine carcinoma.