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Hypopharynx - Postcricoid Space SCC - N/M Staging

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0:01

Hello everyone.

0:03

Dr. Sydney Levy here.

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I'm continuing our discussion of the staging

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of this post-cricoid region sample squamous

0:11

cell malignancy, which we've been looking at.

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I'd like to focus on nodal staging.

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So this tumor has bilateral cervical

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lymph nodes within levels 2 and 3,

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all of which measure less than three centimeters.

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So we have a node here, a node here.

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There are further nodes mostly on the right

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hand side, but also on the left-hand side,

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none of which measure more than 3 centimeters.

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None of these lymph nodes demonstrated an infiltrative

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or blurred margin to suggest extranodal extension.

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So based on this assessment, we have bilateral

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lymphadenopathy, all of which measures less

0:56

than 6 cm without macroscopic evidence of

1:00

extranodal extension on MRI, therefore we have

1:04

an N2C tumor, according to the staging system.

1:09

This tumor needs to be M staged,

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and in this case, it is positive.

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In this case, the patient has bony metastases.

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We can identify on the T1-weighted imaging a T2 vertebral

1:23

level metastasis without evidence of pathological

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fracture or canal stenosis at this level.

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And in addition to that, there

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is also involvement of C7 as well.

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So, in summary, this patient has an advanced,

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relatively advanced malignancy,

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which corresponds to a T4A staging based on esophageal

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muscle involvement extending into the cervical trachea.

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It is an N2C tumor due to the fact that it has

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bilateral lymphadenopathy, all measuring less than

2:03

6 cm without evidence of extranodal extension.

2:07

And it is an M1 tumor due to the

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presence of at least two bony metastases.

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This patient does require completion of

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staging in the form of CT or PET CT imaging.

Report

Description

Faculty

Sidney Levy, PhD, MBBS

Radiologist and Nuclear Medicine Specialist

I-MED

Tags

Neuroradiology

Neuro

Neoplastic

MRI

Head and Neck

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