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Laryngeal SCC: N and M Staging

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Hello everyone.

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Dr. Sidney Levy here, continuing our discussion on the staging

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of laryngeal squamous cell malignancy using our example case

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of a large transglottic laryngeal squamous cell carcinoma.

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So in this case, there are two closely adjacent right

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sided ipsilateral levels 2A/3 lymph nodes.

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The largest lymph node measures less than 3 centimeters.

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And there are no lymph nodes within the left sided neck.

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On T2 and T1 weighted imaging, there is no evidence

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to suggest radiological extranodal extension.

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But remember that this is primarily

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a clinico-pathological diagnosis.

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So, therefore, this tumor may be classified as

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an N2B tumor due to the fact there are multiple

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ipsilateral lymph nodes measuring less than six

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centimeters with no evidence of extranodal extension.

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There was no evidence of distant

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disease in this head and neck study.

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So it's an M0 based on this MRI.

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But remember, further imaging such as CT

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or PET/CT is required to complete staging.

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So in summary, this tumor based on this vignette

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and the previous vignette is a T4A tumor due

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to the fact that there is involvement of both the

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inner and outer cortices of the thyroid cartilage.

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It is an N2B tumor due to the fact there are

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multiple ipsilateral lymph nodes measuring

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less than six centimeters without evidence of

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extranodal extension and an M0 tumor so far.

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And in addition, we must make mention of the fact that

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the airway is compromised at the level of the supraglottis

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and the glottis with moderate to marked stenosis.

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This should be rung through to the referrer.

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And lastly, it is a bilateral tumor involving all

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three subsites of the larynx: supraglottis, glottis,

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and subglottis, but centered at the glottis.

Report

Description

Faculty

Sidney Levy, PhD, MBBS

Radiologist and Nuclear Medicine Specialist

I-MED

Tags

Neuroradiology

Neuro

Neoplastic

MRI

Larynx

Head and Neck

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