Endoscopic Submucosal Dissection for Treatment of Localized Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: A Case Series

Background/Aims: The treatment for gastric mucosa-associated lymphoid tissue lymphoma (MALToma) generally involves eradication of Helicobacter pylori . However, MALToma lesions may recur even without H. pylori re-infection. Furthermore, the remission rate of H. pylori -negative MALToma after eradication is low. Therefore, herein, we report on endoscopic submucosal dissection (ESD) as a treatment strategy for gastric MALToma. Methods: We retrospectively reviewed the data of all patients of gastric MALToma who underwent endoscopic resection at our institution between January 2000 and December 2021. Clinical remission was defined as complete histological remission or probable minimal residual disease according to the GELA grading system for post-treatment evaluation of gastric MALToma. Results: Six patients with gastric MALToma underwent ESD. Two patients were diagnosed with gastric MALToma, which improved after eradication treatment and relapsed approximately 36 and 41 months later, respectively. These patients had singular lesions localized to the mucosa and did not experience H. pylori re-infection. The lesions were successfully removed via ESD. The remaining four patients had H. pylori -negative gastric MALToma. These patients also had single, localized lesions that were removed via ESD. All the patients remained in clinical remission until the final follow-up. Conclusions: ESD is a safe and effective intervention for H. pylori -negative gastric MALToma when the lesion is single and confined to the mucosal layer. (Korean J Helicobacter Up Gastrointest Res 2023 Aug 30. [Epub ahead of print])