A 58-year-old chronic smoker presents with hoarseness for 4 months. Laryngoscopy reveals a lesion involving the anterior commissure with extension to the contralateral cord and subglottis. According to AJCC TNM staging, this is classified as:
- A T1b
- B T3 ✓
- C T2
- D T4a
Correct answer: B. T3
Explanation
Glottic carcinoma involving both vocal cords (via anterior commissure = T1b) with subglottic extension or impaired cord mobility is classified as T3 (not T4a, which requires invasion through the thyroid cartilage or extra-laryngeal soft tissue). T2 means extension to supraglottis/subglottis with normal cord mobility. The anterior commissure involvement staging is nuanced: T1b is bilateral cord lesion without extension; adding subglottic extension or cord fixation upgrades it.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.