For instance, in one ALK-1-positive thyroid IMT case, the patient had concurrent Hashimoto’s thyroiditis, suggesting that chronic inflammation may contribute to IMT development or progression (12).In another ALK-positive case, the patient underwent partial thyroidectomy and developed metastasis to the right gluteus maximus 17 months post-surgery (9). The gene discussed is ALK; the disease is inflammatory myofibroblastic tumor.