<i>ALK</i> rearrangements have rarely been reported in S100- and CD34-co-expressing soft tissue neoplasms with lipofibromatosis-like neural tumor (LPFNT) pattern or stromal and perivascular hyalinization, mimicking <i>NTRK</i>-rearranged spindle cell tumors. This evidence concerns the gene ALK and spindle cell neoplasm.