Symptoms do not usually occur until the mass is large. Typical initial symptoms include minimal change in voice or in swallowing function. Larger masses will affect function of the nasopharynx, eustachian tube, and oropharynx. Parotid neoplasms can affect function of the facial nerve, which courses through the parotid gland to innervate the facial muscles of expression. Tumor masses invading or impinging upon the nerve may damage nerve function.
Salivary cancers can also affect sensory nerves.
Patients may present with pain or paraesthesia associated with cranial nerve invasion. Patients who present with neurologic symptoms are more likely to have malignant lesions and a poor prognosis. Minor salivary gland cancers typically present with signs or symptoms referable to their anatomic site of origin. Minor salivary gland tumors may be asymptomatic. In a series of 40 patients from M.D. Anderson with minor salivary gland cancers of the palate, the common presenting symptom was a usually painless mass.