Published online Nov 15, 2024. doi: 10.4251/wjgo.v16.i11.4309
Revised: June 3, 2024
Accepted: June 26, 2024
Published online: November 15, 2024
Processing time: 221 Days and 7.7 Hours
In this editorial, we comment on an article by Xu et al. This article describes a case of crawling-type gastric adenocarcinoma (CRA) distinguished by its rare occurrence and diagnostic complexity. We reviewed the detailed case-report findings showcasing clinical, pathological, and molecular characteristics of CRA that shed light on its elusive nature and challenges for early detection and treatment. This case underscored the significance of advanced diagnostic tools such as endoscopic submucosal dissection. Emphasis was placed on the molecular peculiarities of CRA, including the higher mutation rates of genes such as TP53 and RHOA and the notable absence of HER2 amplification, differentiating it from more conventional forms of gastric adenocarcinoma. In this editorial, we advocate for a multidisciplinary approach to effectively manage this rare subtype and highlight the necessity for precision in both diagnostic and therapeutic strategies. Moreover, a heightened awareness urging the adoption of advanced diagnostic techniques and collaborative approaches is necessary among clinicians and researchers. We aim to contribute to the ongoing discourse in gastrointestinal oncology, emphasizing the importance of recognizing and addressing the complexities associated with rare cancer subtypes such as CRA.
Core Tip: Crawling-type gastric adenocarcinoma (CRA) is characterized by its elusive presentation and propensity for lateral expansion within the mucosal layer, posing significant challenges to early detection. This study emphasizes the need for a multidisciplinary approach to achieve accurate diagnosis and effective treatment. The findings reveal distinct molecular features of CRA including the notably increased mutation frequencies in the TP53 and RHOA genes, and the absence of HER2 amplification. These characteristics highlight the critical need for precision in diagnostic and therapeutic modalities. The objective is to augment clinical awareness, thereby facilitating prompt identification and efficient management of this subtype of gastric cancer.