Subsequently, Gonzalez et al. reported an extremely WD adenocarcinoma subtype termed an “adenoma-like adenocarcinoma,” which had the following characteristics: 1) a lower N stage compared to the same T stage, 2) a better prognosis than conventional adenocarcinoma, 3) difficulty in distinguishing the adenoma from the carcinoma on biopsy specimens, and 4) frequent KRAS mutation (58%) [13]. This evidence concerns the gene KRAS and adenocarcinoma.