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Salivary glands

Miscellaneous

TNM staging

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 26 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Use for staging major salivary gland tumors only (parotid, submandibular, sublingual glands)
● Tumors arising in minor salivary glands are staged according to anatomic site of origin

Primary tumor (T)
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TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
T1: Tumor 2 cm or less in greatest dimension without extraparenchymal extension*
T2: Tumor more than 2 cm but not more than 4 cm in greatest dimension without extraparenchymal extension*
T3: Tumor more than 4 cm in greatest dimension or tumor having extraparenchymal extension*
T4a: Moderately advanced disease; tumor invades skin, mandible, ear canal or facial nerve
T4b: Very advanced disease; tumor invades skull base or pterygoid plates or encases carotid artery

● Note: extraparenchymal extension is clinical or macroscopic evidence of invasion of soft tissues or nerve (except T4a and T4b)
● Microscopic evidence alone does not constitute extraparenchymal extension

Regional lymph nodes (N)
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NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension
N2: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
N2a: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension
N2b: Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension
N2c: Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
N3: Metastasis in a lymph node more than 6 cm in greatest dimension

Distant metastasis (M)
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M0: No distant metastasis
M1: Distant metastasis
Mx: Cannot be assessed

Stage grouping
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I: T1 N0 M0
II: T2 N0 M0
III: T3 N0 M0 or T1-3 N1 M0
IVA: T4a N0-1 M0 or T1-T4a N2 M0
IVB: Any T N3 M0 or T4b any N M0
IVC: Any T any N M1

End of Salivary glands > Miscellaneous > TNM staging

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