Conservative Management of Primary Thyroid Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma: A Case Report and Review of Multidisciplinary Approach

Primary thyroid mucosa-associated lymphoid tissue (MALT) lymphoma is a rare condition. It often progresses slowly and has subtle symptoms. This condition is usually linked with chronic thyroiditis. We present the case of a 70-year-old man who experienced progressive dysphagia and neck swelling for six months. He was found to have a large multinodular goitre and background hypothyroidism. Despite a fine-needle aspiration that did not provide a diagnosis, doctors decided to perform surgery because of his compressive symptoms. Histopathology showed extranodal marginal zone MALT lymphoma alongside chronic lymphocytic thyroiditis. Postoperative PET/CT and bone marrow tests revealed no signs of systemic involvement. After a review by a multidisciplinary tumor board, the patient was treated conservatively without additional therapy. He showed no signs of recurrence during the one-year follow-up. This case highlights the diagnostic challenges and underscores the importance of considering MALT lymphoma when evaluating goitre. It also demonstrates that individualized, conservative management guided by a multidisciplinary team can lead to excellent outcomes in localized disease.