Considering RMC in the differential diagnosis, attention to histologic clues, special immunostains, imaging, and a complete history are necessary to differentiate RMC from its possible mimics, including renal collecting duct carcinoma, ALK-rearranged RCC, poorly differentiated RCC, urothelial carcinoma, and extrarenal malignancies [10]. The gene discussed is ALK; the disease is renal cell carcinoma.