Autoimmune gastritis (AIG) is a chronic inflammatory disease characterized by atrophy of the acid-producing mucosa of the stomach body as a result of autoimmune damage to the parietal cells. In presence of long-lasting AIG, development of epithelial neoplasms, including hyperplastic polyps and neoplastic processes, is possible, that significantly complicates timely diagnosis of malignant gastric neoplasms.

OBJECTIVE

To present a clinical case of multicentric polymorphic stomach cancer developed in addition to AIG with emphasis on diagnostic difficulties and the need to comply with regular medical check-up standards.

CASE REPORT

Patient, 66 years old, has been under outpatient follow-up since 2010 for B₁₂-deficiency and iron deficiency anemia, autoimmune thyroiditis, chronic gastritis and gastric polyposis. However, the patient did not receive sufficient medical care. 15 years after the establishment of «chronic gastritis» diagnosis, multicentric polymorphic stomach cancer in presence of AIG has been revealed when reffering to oncological clinic. Gastrectomy with D2 lymph node dissection was performed. According to the results of histological study, the following diagnosis was established: multicentric polymorphic cancer of the stomach body with cT1a(m)pN0M0, stage I, clinical group 2 [C16.8], including well-differentiated adenocarcinoma G1 (intestinal type according to Lauren), poorly differentiated signet ring cell adenocarcinoma G3 (diffuse type according to Lauren), as well as neuroendocrine tumors of the stomach G2.

CONCLUSION

This clinical case emphasizes the complexity of early diagnosis of autoimmune gastritis and keeps up to date the importance of adherence to diagnostic algorithms and follow-up standards for patients with chronic gastritis.