Mycosis fungoides as a disorder of reticulo-endothelial system occurs in the eczematous or psoriatic stage, progresses to infiltrated plaque stage and finally to tumorous form with or without systemic spread. The head and neck is rarely involved. A case is presented in which the disease process started as a tumor (d'emblee type) and remained localized in the head and neck region without a generalized spread. The tumorous lesion rapidly increased in size and involved deeper tissues of the neck to cause infranuclear facial palsy and medial bulging of the tonsil' it also extended in the superior mediastinum casuing pressure on the trachea and the esophagus. The patient died of respiratory failure.