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Signs & Symptoms

Many are "silent" tumors—no pain or other symptoms until tumors reach advanced stages.

Cervical lymph node metastases at the time of diagnosis (70% for pyriform sinus, 40% for postcricoid, 50% for posterior hypopharynx, 75% for nasopharynx, 70% for tonsil and base of tongue, 30-65% of soft palate and pharyngeal wall, depending on the size of the primary).

General symptoms

Mass, ulcer, referred or localized pain, neurologic defects, hoarseness.

Larynx: supraglottis

Sore throat, painful swallowing (odynophagia), difficulty swallowing (dysphagia), ear pain (otalgia); glottis and subglottis—hoarseness; subglottis—neck mass, airway dizziness, hemoptysis, stridor.

Nasopharynx

Nasal obstruction, epistaxis, tinnitus, sore throat, headache, diminished hearing, facial pain, serous otitis, middle ear effusion, neckmass.

Oropharynx

Pain, sore throat, dysphagia, pain radiating to the ear; asymptomatic mass in neck, hemoptysis.

Hypopharynx

Odynophagia, referred otalgia, dysphagia; hoarseness; hemoptysis.

Thyroid

Cold nodule in thyroid; neck mass, previous dx of neoplasia (MEN) syndrome (type II); sudden development of pain, hoarseness, or dysphagia may indicate a highly invasive thyroid cancer.

Parotid gland

Asymptomatic swelling; occasionally painful mass.

Paranasal sinuses and nasal cavity

Early stages are asymptomatic; advanced stages develop dull face or tooth pain, loose teeth, nasal obstruction, rhinorrhea, nosebleeds, and other symptoms.

Plummer-Vinson syndrome (achlorhydria, sideropenic anemia, atrophy of the mucous membranes of the mouth, pharynx, and esophagus)

Associated with oral cavity and hypopharynx cancers.

Multiple endocrine neoplasia (MEN) syndrome

Multiple benign or malignant tumors of endocrine organs, pheochromocytoma of adrenal gland, secretion of calcitonin—associated with familial medullary carcinoma of the thyroid.