Mucosa-associated lymphoid tissue (
MALT) lymphoma is increasing common in various sites; however,
MALT lymphoma in the esophagus is still rare, so its diagnostic features have not yet been well recognized and optimal treatment has not been properly discussed. Though
radiotherapy is widely preferred for gastric and orbital
MALT lymphoma, surgery has been the most frequently reported treatment for esophageal
MALT lymphoma. This raises the question: why not
radiotherapy for esophageal
MALT lymphoma instead of surgery? The only reported case of definitive
radiotherapy for esophageal
MALT lymphoma lacks follow-up data. Three years ago (2007), we treated a 59-year-old male patient with a large esophageal submucosal
tumor, diagnosed as
MALT lymphoma, with 36 Gy of solo external beam
radiotherapy. The
tumor was 15 cm in craniocaudal length, homogeneously weakly contrast-enhanced on X-ray computed tomography (CT), homogeneously hypoechoic and clearly demarcated from the surrounding adventitia, and had a concave pattern between the folds. During and after
radiotherapy, no treatment-related complications occurred except for transient Grade 2
leukocytopenia. The
tumor showed remarkable reduction and histological negativity in the next month. Over the follow-up period, no recurrence was observed in semiannual PET/CT/MRI studies. Taking the current observation with the well known effectiveness of
radiotherapy for
MALT lymphoma in various other sites, we recommend considering
radiotherapy as a reasonable less-invasive treatment for this rare entity.