Esophageal submucosal tumors are rare, but their pathological types are diverse. In addition to the relatively common leiomyomas, some rare submucosal lesions are occasionally reported. Waldeyer's ring is described as a unique subtype of mucosa-associated lymphoid tissue, located in the naso-oropharynx. Studies have reported that Waldeyer's ring is the most common site of primary extranodal lymphoma in the head and neck. Interestingly, we encountered an esophageal submucosal tumor-like lesion similar to the tonsillar structures of Waldeyer's ring. A 38-year-old man underwent esophagoscopy after experiencing swallowing discomfort for 3 months. A protruding submucosal mass with slightly rough mucosa was found at the cervical esophagus approximately 20 cm from the incisors. Considering the possibility of the coexistence of a submucosal tumor and a mucosal lesion, as well as the continuous symptoms of swallowing discomfort, the patient underwent endoscopic submucosal dissection. The lesion was removed en bloc. However, histology revealed a lesion similar to the tonsillar structure of Waldeyer's ring between the lamina propria and submucosa. The patient was followed up for 6 months without recurrence or complaints. We report a new submucosal lesion and discuss its origin and treatment. Diagnostic ESD might be an effective option until its malignant potential is clarified.
Keywords: Waldeyer’s ring; cervical esophagus; endoscopic submucosal dissection; submucosal tumor-like lesion.