Recurrent uterine inflammatory myofibroblastic tumor previously managed as leiomyosarcoma has sustained response to alectinib

•Inflammatory myofibroblastic tumors can mimic leiomyosarcoma histologically.•Highlights the role of molecular testing in the diagnosis and management of uterine mesenchymal tumors•Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase involved in cellular growth.•Alectinib is one of several ALK inhibitors FDA-approved for patients with ALK-fusion positive lung cancers•Supports the paradigm shift toward developing molecularly targeted therapies rather than disease site-specific treatments