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Sinonasal SCC - TNM Staging

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Hello everyone, Sidney Levy here continuing

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our discussion on the diagnosis and staging

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of Sinonasal Squamous Cell Malignancy.

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In this vignette, I would like to formally stage our

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example, Right Nasal Cavity Squamous Cell Carcinoma.

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Firstly, I will draw it for you so

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that we're all clear on its boundaries.

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I have axial, coronal, and sagittal projections

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with post-contrast T1-weighted imaging with fat suppression.

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Just drawing the outline of the tumor.

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This tumor is a large tumor centered on

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the right nasal cavity, which has then spread

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superiorly into the ethmoidal air cells.

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And then, it has continued to spread

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superiorly through the cribriform plate

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into the anterior cranial fossa where

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it is eliciting vasogenic edema in the

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adjacent orbital aspect of the frontal lobe.

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So based on our last vignette where we discussed the

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general definitions of T staging, this tumor cannot

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be a T1 tumor because it is involving more than one

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subsite of the nasal cavity and ethmoidal sinus.

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It is involving the nasal cavity and the ethmoidal sinus.

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In addition to that, it has invaded the cribriform plate.

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And based on that, it is upgraded

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to a T3 tumor automatically.

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A T4a tumor involves minimal extension

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to the anterior cranial fossa.

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So this tumor is at least a T4a tumor.

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Very advanced local disease involves

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invasion of the dura or the brain.

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This tumor is likely involving the dura, and the

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reason why we say that is we can see that there is some

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enhancement of anterior cranial fossa dura in this area.

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So in summary, from a T staging perspective,

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this tumor is at least a T4a tumor and likely a T4b tumor

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by virtue of involvement of the dura of the anterior cranial

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fossa, which you can see as enhancement here.

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From an N and an M perspective, this tumor

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is straightforward as there is no abnormal

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lymphadenopathy within the head or neck.

Report

Description

Faculty

Sidney Levy, PhD, MBBS

Radiologist and Nuclear Medicine Specialist

I-MED

Tags

Paranasal sinuses

Neuroradiology

Neuro

Neoplastic

MRI

Head and Neck

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