Favorable Outcome of Nasal-Type Extranodal Natural Killer (NK)/T-Cell Lymphoma in a Very Elderly Patient Treated With Radiotherapy Alone

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTCL), is a rare and aggressive Epstein-Barr virus <i>(</i>EBV)-associated malignancy, typically affecting middle-aged individuals. Cases in patients over 80 are extremely rare. We report an 88-year-old woman, the oldest known case, successfully treated with radiotherapy alone. She presented with erythema and swelling of the right cheek and nasal cavity, initially misdiagnosed as facial cellulitis. A skin biopsy revealed atypical CD3⁺/CD56⁺ lymphoid cells, and EBER positivity confirmed EBV involvement. Imaging showed localized disease without systemic spread. Due to her advanced age and comorbidities, chemotherapy was not feasible, and she received radiotherapy alone, resulting in complete remission without recurrence. This case highlights the effectiveness of radiotherapy in localized ENKTCL and suggests that even very elderly patients can achieve favorable outcomes with appropriate treatment.