A 58-year-old male presents with a 2.5 cm carcinoma of the mobile tongue (T2) with a single ipsilateral level II lymph node measuring 2.8 cm (clinically palpable, not fixed). Staging under the AJCC 8th edition would be:

• A Stage IVA (T2N2bM0)
• B Stage IVA (T2N1M0) due to extranodal extension
• C Stage III (T2N2aM0)
• D Stage III (T2N1M0) ✓

Explanation

Under the AJCC 8th edition for oral cavity cancers, a single ipsilateral regional lymph node measuring ≤3 cm without extranodal extension (ENE) is classified as N1. Combined with T2 (tumor >2 cm but ≤4 cm), this gives T2N1M0 = Stage III. ENE, if present, upgrades N classification significantly (N1 with ENE becomes N2a under the new ENE-based N staging introduced in the 8th edition). No ENE is mentioned here so N1 stands, making this Stage III.

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

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Written and medically reviewed by the StethoPrep medical team.