AUTHOR=Wang Yingqi , Liu Zijin , Gao Wei , Jia Tianxu , Hong Jiayi , Cai Ling , She Jing , Zhai Huihong 

TITLE=Malignant transformation of gastric hyperplastic polyps in an autoimmune gastritis patient—a case report and literature review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1693184

DOI=10.3389/fmed.2025.1693184

ISSN=2296-858X

ABSTRACT=The cancer risk in autoimmune gastritis (AIG) remains controversial. Malignant transformation of gastric hyperplastic polyps (GHPs) in an AIG patient is rare. The esophagogastroduodenoscopy (EGD) of a 75-year-old male patient showed a 0.8 cm GHP. Endoscopic resection was conducted, and the pathological findings showed high-grade dysplasia and intramucosal moderately differentiated adenocarcinoma. Follow-up at 1 year confirmed no sign of recurrence. 18 months post-operatively, another EGD confirmed advanced-stage AIG, evidenced by characteristic endoscopic/histologic findings, positive anti-parietal cell antibody, low pepsinogen I/II ratio, significantly elevated gastrin-17, low vitamin B12, and negative Helicobacter pylori (Hp) serology. Concurrent Hashimoto's thyroiditis and vitiligo were also noted. We here report a rare case of early malignant transformation of a small GHP arising in a context of AIG. Elevated gastrin levels may be a potential risk factor for cancer development in Hp-negative AIG. Endoscopic resection can be considered for early-stage cancerous transformation of GHPs.