ALK-positive histiocytosis should be included in the differential diagnosis of adrenal neoplasms, and routine ALK testing is recommended to avoid misdiagnosis and overly aggressive therapy.
To our knowledge, this is the first documentation of primary ALK-positive histiocytosis in the adrenal gland. The presence of anaplastic features poses a high risk of misdiagnosis as a sarcoma or carcinoma, potentially leading to overly aggressive therapy. Therefore, we advocate for the inclusion of this entity in the differential diagnosis of adrenal neoplasms and recommend routine ALK testing in similar challenging cases to guide precise management and avoid therapeutic errors.
Ma et al. (Fri,) studied this question.