This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
All are true about carcinoma palate, except - 
Select and explain. 
A. Slow growing, B. Bilateral lymphatic spread, C. Adenocarcinoma, D. Presents with pain
D: Presents with pain
Answer: D: Presents with pain 
Explanation: Carcinoma of the hard pate is either squamous or glandular variety.
Glandular variety arises from minor salivary glands and it can be of following varieties.

a) Adenoid Cystic 
b) Mucoepidermoid
c) Adenocarcinoma (a common site for minor salivary gland tumours is the junction of the hard and soft palate)
Clinical features -

It is a slow-growing tumor and remains superficial for prolonged periods before extending into the periosteum
It usually presents as a superficial ulcer with rolled out edges.
It usually gives no symptoms except painless irregularity on the palate felt by the tongue.
Lymphatic metastasis is not common may spread to submandibular and upper jugular node
T/T → Small tumors → Local excision (most commonly along with bone because of close adherence of the mucosa to the palate)
Large tumors → Maxillectomy Adjuvant radiotherapy is given for advanced lesions.

About option 'b' i.e. Bilateral lymphatic spread
Bilateral lymphatic spread is common in following tumors of the head & neck

lower lip
supraglottis
the base of tongue &
soft palate