From a histopathological perspective, ALK-RCC is defined by heterogeneous and mixed morphology and has a wide differential diagnosis including fumarate hydratase (FH)-deficient RCC, SMARCB1-deficient renal medullary carcinoma, collecting duct carcinoma, papillary RCC, MiT family translocation RCC, and mucinous tubular and spindle-cell carcinoma (MTSCC) [9]. Here, FH is linked to collecting duct carcinoma.