A 55-year-old male smoker presents with progressive hoarseness for 4 months. Laryngoscopy shows a lesion involving the anterior commissure with bilateral vocal cord involvement. On microlaryngoscopy, the tumor is limited to the vocal cords with no fixation. CT shows tumor crossing the anterior commissure. Under AJCC staging this is classified as T2 or T3 based on the specific AJCC 8th edition criterion. Which feature would upgrade this to T3?

• A Bilateral vocal cord involvement alone
• B Anterior commissure involvement
• C Vocal cord fixation ✓
• D Impaired vocal cord mobility (not fixation)

Explanation

For glottic carcinoma under AJCC 8th edition: T1 = tumor limited to vocal cord(s) with normal mobility; T2 = tumor extends to supraglottis or subglottis, or impaired vocal cord mobility; T3 = tumor limited to larynx with vocal cord fixation (not just impaired mobility) or invasion of paraglottic space or inner cortex of thyroid cartilage. Vocal cord fixation (not just impaired mobility) upgrades to T3. Anterior commissure involvement with bilateral cords but normal or impaired (but not fixed) mobility remains T2. Bilateral involvement alone with normal mobility is T1b.

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

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Written and medically reviewed by the StethoPrep medical team.