It is very important for clinicians to understand that nonulcerated, firm, dome-shaped, nonpainful palatal swellings, if not inflammatory in nature, are probably arising in the palatal accessory salivary glands. The differential diagnosis must include benign mixed tumors; adenoid cystic carcinoma, and necrotizing sialometaplasia, which is usually ulcerated. Statistically, the possibility that the lesion is malignant is slightly greater than the possibility that it is benign. Incisional biopsy must be performed on these lesions to determine the proper treatment and management regimen.