CDH1 and adenocarcinoma: Germline CDH1 mutations are associated with hereditary diffuse gastric cancer,14 while sporadic mutations are relatively common (about 20%) in poorly cohesive gastric carcinomas13,14 and in appendiceal GCAs, where these mutations could represent additional hits transforming the neoplasm into a poorly differentiated adenocarcinoma with a dyshesive cell spread.43