ENT · Head and Neck Oncology — Staging and Management (Oral, Laryngeal, Salivary, Neck Nodes)

A 58-year-old male presents with a 3 cm ulcerative lesion on the lateral tongue. Biopsy confirms squamous cell carcinoma. CT neck shows a single ipsilateral 2.5 cm lymph node with no extranodal extension (ENE). According to AJCC 8th edition TNM staging, what is the N category?

  • A N2a
  • B N1
  • C N2b
  • D N3a
Correct answer: B. N1

Explanation

In AJCC 8th edition for HPV-negative oral cavity SCC, N1 denotes a single ipsilateral lymph node ≤3 cm in greatest dimension with no extranodal extension. N2a is a single ipsilateral node >3 cm but ≤6 cm without ENE, or any node with clinical ENE is N3b. A 2.5 cm single ipsilateral node without ENE correctly classifies as N1.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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