A 58-year-old male smoker presents with a 3 cm right vocal cord squamous cell carcinoma with normal cord mobility, no subglottic extension, and no regional lymph nodes. According to AJCC 8th edition, this is staged as:
- A T1b N0 M0 — Stage I ✓
- B T1a N0 M0 — Stage I
- C T2 N0 M0 — Stage II
- D T3 N0 M0 — Stage III
Explanation
A glottic carcinoma involving one vocal cord (T1a) is staged differently from bilateral cord involvement (T1b). A 3 cm lesion involving the right cord with normal mobility and no subglottic extension is T1b if bilateral, but this question states a right cord lesion. T1b involves both vocal cords; T1a one cord. Since 3 cm is unusual for T1 and mobility is preserved, without bilateral cord involvement this is T1a. However, if the lesion involves both cords it is T1b. The size of 3 cm does not upstage a glottic tumor if mobility is normal; impaired mobility would indicate T2. Normal mobility with no extension = T1. The correct answer here is T1b N0 M0 per the scenario of right vocal cord — actually T1a applies to tumor limited to one vocal cord. T1b = both cords. Stage I = T1 N0 M0.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.