A patient with a 4 cm squamous cell carcinoma of the floor of mouth with a single ipsilateral lymph node 2.5 cm in maximum dimension, clinically node positive with no extranodal extension, is staged as:
- A Stage IVA (T2 N1 M0) — AJCC 8th edition
- B Stage III (T3 N1 M0)
- C Stage III (T2 N1 M0) ✓
- D Stage IVA (T3 N2a M0)
Correct answer: C. Stage III (T2 N1 M0)
Explanation
Per AJCC 8th edition, a 4 cm floor-of-mouth SCC is T2 (2–4 cm without muscle invasion). A single ipsilateral node ≤3 cm without ENE is N1. T2 N1 M0 corresponds to Stage III for oral cavity SCC. Stage IVA requires T4a or N2 disease. Correct staging is critical for treatment planning (surgery ± adjuvant vs. definitive CRT).
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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