# Hidden in Plain Sight: Delayed Diagnosis of Poorly Cohesive Gastric Carcinoma in a Young Male Patient

## TL;DR

A young man with persistent heartburn was later diagnosed with aggressive gastric cancer, highlighting the need for earlier screening in young adults.

## Contribution

This case emphasizes the rising incidence of early-onset gastric cancer and the importance of timely diagnosis in young patients.

## Key findings

- The patient had non-hereditary, poorly cohesive gastric adenocarcinoma despite H. pylori treatment and acid suppression.
- Persistent pyrosis in young adults may be an early sign of gastric cancer and warrants closer monitoring.
- Early-onset gastric cancer is increasing and differs from late-onset cases in etiology and presentation.

## Abstract

Poorly cohesive gastric adenocarcinoma is classified as a diffuse type of gastrointestinal tract tumor composed of undifferentiated cells with an inherent propensity for aggressive behavior. Recent trends in surveillance indicate that gastric cancer (GC) is affecting younger adults and is distinct from GC that occurs later in life. Early-onset gastric cancer (EOGC) is associated with various environmental and genetic factors. Younger patients with recurrent pyrosis may warrant earlier surveillance in light of this worrisome trend. Herein, we discuss a young male patient who developed non-hereditary, poorly cohesive gastric adenocarcinoma with an extended history of pyrosis despite long-term acid suppression and triple therapy for Helicobacter pylori (H. pylori).