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 diziness, 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.