Molecularly, approximately 60% of HIMTs feature anaplastic lymphoma kinase (ALK) rearrangements, particularly in younger patients.[3] ALK-negative tumors frequently harbor fusions in C-ros oncogene 1 receptor tyrosine kinase (ROS1), neurotrophic receptor tyrosine kinase 3 (NTRK3), or rearranged during transfection and demonstrate more aggressive behavior with poorer therapeutic responses.[4–6] HIMT is often misdiagnosed as hepatocellular carcinoma, cholangiocarcinoma, or abscess due to overlapping clinical and radiological features. The gene discussed is ALK; the disease is hepatocellular carcinoma.