Despite being limited by the small sample size, due to the rarity of this histotype, our study has shown that the genomic profile of colorectal ASC is similar to that of conventional CRC, with an overlapping prevalence of driver mutations, such as TP53, APC, KRAS, and BRAF. Notably, an enrichment of GNAS mutations, a lower prevalence of PIK3CA mutations, and the presence of infrequent CNVs in comparison to CRC were observed. The gene discussed is APC; the disease is colorectal carcinoma.