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Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade extra nodal often gastric condition. MALT lymphoma of the head and neck has been reported in the salivary gland, thyroid, larynx, orbit, and skin. A 76-year-old woman seen for double vision was found in neuro opthalmological examination to have trochlear and oculomoter nerve palsy. Epipharyngeal endoscopy showed a submucosal tumor in the posterior epipharynx wall. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a mass lesion of the epipharynx, pterygopalatine fossa, and cavernous sinus. Endoscopic tumor biopsy performed twice for the epipharynx and for the pterygopalatine fossa was pathologically difficult to differentiate from lymphoid tissue and lymphoma hypertrophy. Clonal Southern blot analysis showed clonal rearrangement of the heavy immunoglobulin gene chain, yielding a diagnosis of MALT lymphoma.

Endoscopic examination, including narrow-band imaging (NBI), is being increasingly used to detect early hypopharygeal cancer. Because these high-risk cases have already often undergone radiotherapy for esophageal cancer, early hypopharygeal cancer is a good indication for endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Slightly larger tumors, however, require partial hypopharyngotomy preserving the larynx. Since reconstruction with a free flap may be highly invasive, we reported using an anterior chest skin flap as a useful alternative in pharyngeal reconstruction.

Pediatric thyroid gland carcinoma is uncommon, representing less than 1% of all thyroid cancer. We report cases of thyroid carcinoma in a 9-year-old boy and a 12-year-old girl, both with dyspnea and lateral cervical tumors, and both found in computed tomography (CT) and fine-needle aspiration cytology. Lung metastasis was found in chest CT on presentation. Because both were in the bilateral cervix, we conducted total thyroidectomy and bilateral selective neck dissection level 2-6. Case 1 had recurrent laryngeal nerve and tracheal invasion. Radioactive iodine therapy was administered to both postperatively for lung metastasis. Children with well-differentiated papillary and follicular carcinoma are reported to have a substantially better prognosis than adults despite comparatively high regional and distant metastasis incidence. Appropriate diagnosis, surgical procedure choice, and careful follow-up are thus important in pediatric thyroid cancer.