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Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a highly aggressive variant of inflammatory myofibroblastic tumor (IMT). It is characterized immunohistologically by anaplastic lymphoma kinase (ALK) overexpression and genetic rearrangements in selected cases. The clinical significance of ALK rearrangement on radiotherapy was never reported in EIMS. Here we report a case of locally advanced rectal EIMS. In 2017, a 62-year-old woman was offered laparoscopic abdominoperineal resectiondoi:10.21037/tro.2020.04.01 fatcat:oelvtckgqrgm3p32cvpxrylxae