Xu YW, Song Y, Tian J, Zhang BC, Yang YS, Wang J. Clinical pathological characteristics of “crawling-type” gastric adenocarcinoma cancer: A case report. World J Gastrointest Oncol 2024; 16(4): 1660-1667 [PMID: 38660640 DOI: 10.4251/wjgo.v16.i4.1660]
Corresponding Author of This Article
Jing Wang, MD, PhD, Dean, Doctor, Department of Gastroenterology, Songjiang Hospital, School of Medicine, Shanghai Jiaotong University, No. 746 Zhongsanzhong Road, Songjiang District, Shanghai 201600, China. wangj0081@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1660-1667 Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1660
Clinical pathological characteristics of “crawling-type” gastric adenocarcinoma cancer: A case report
Yong-Wei Xu, Yan Song, Jun Tian, Ba-Cui Zhang, Yu-Sheng Yang, Jing Wang
Yong-Wei Xu, Yan Song, Jun Tian, Ba-Cui Zhang, Jing Wang, Department of Gastroenterology, Songjiang Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 201600, China
Yu-Sheng Yang, Department of Pathology, Songjiang Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 201600, China
Co-first authors: Yong-Wei Xu and Song Yan.
Author contributions: Xu YW and Song Y contributed equally to this work; Tian J contributed to the collection of data; Zhang BC checked the pictures; Yang YS contributed to the pathological analysis; Wang J contributed to the revision of the manuscript; all authors agree to the publication of the manuscript.
Supported bythe Songjiang District Tackling Key Science and Technology Research Projects, No. 20sjkjgg32; Excellent Young Talents Training Program of Songjiang Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, No. QNRC-004; and Science and Technology project of Songjiang District, No. 22SJKJGG81.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Wang, MD, PhD, Dean, Doctor, Department of Gastroenterology, Songjiang Hospital, School of Medicine, Shanghai Jiaotong University, No. 746 Zhongsanzhong Road, Songjiang District, Shanghai 201600, China. wangj0081@126.com
Received: December 17, 2023 Peer-review started: December 17, 2023 First decision: January 10, 2024 Revised: January 16, 2024 Accepted: February 20, 2024 Article in press: February 20, 2024 Published online: April 15, 2024 Processing time: 115 Days and 15.5 Hours
Abstract
BACKGROUND
Gastric cancer (GC) is a significant health problem worldwide, and early detection and accurate diagnosis are crucial for improving patient outcomes. Crawling-type gastric adenocarcinoma is a rare subtype of GC that has unique histopathological and clinical characteristics, and its diagnosis and management can be challenging. This pathological type of GC is also rare.
CASE SUMMARY
Here, we report the case of a patient who underwent ordinary endoscopy, narrow-band imaging, and endoscopic ultrasonography intending to determine the extent of tumor invasion and upper abdominal enhanced computed tomography and whether there was tumor metastasis. Then, endoscopic submucosal dissection was performed. After pathological and immunohistochemical examination, the pathological diagnosis was crawling-type gastric adenocarcinoma. This is a very rare and special pathological type of tumor. This case highlights the importance of using advanced endoscopic techniques and pathological examination in diagnosing and managing gastric crawling-type adenocarcinoma. Moreover, the findings underscore the need for continued research and clinical experience in this rare subtype of GC to improve patient outcomes.
CONCLUSION
The “crawling-type” GC is a rare and specific tumor pathology. It is difficult to identify and diagnose gliomas via endoscopy. The tumor is ill-defined, with a flat appearance and indistinct borders due to the lack of contrast against the background mucosa. Pathology revealed that the tumor cells were hand-like, so the patient has diagnosed with “crawling-type” gastric adenocarcinoma.
Core Tip: “Crawling type” gastric cancer is a rare variant of early gastric cancer. It was once called “Shaking-Hands Structure”, “WHYX Pattern” or “shaking-hands pattern”, which is an important subtype of gastric gland cancer. It is also difficult to diagnose. From an endoscopy perspective, the tumour lacks contrast with the surrounding mucosa, giving it a flat appearance and hazy edges. As a result, early diagnosis of the condition might be challenging.
