Retinoblastoma with extraocular extension to the optic nerve beyond the surgical cut end is classified as which pTNM pathological T stage?
- A pT2a
- B pT3 ✓
- C pT4
- D pT2b
Correct answer: B. pT3
Explanation
In the AJCC 8th edition pTNM pathological staging of retinoblastoma: pT1 = tumor(s) confined to the retina; pT2a = microscopic tumour in the anterior segment or vitreous seeding; pT2b = choroidal invasion (focal or massive); pT3 = optic nerve involvement beyond the lamina cribrosa OR surgical cut end involvement of the optic nerve; pT4 = extraocular extension (invasion of sclera, orbit, or beyond). Optic nerve involvement beyond the cut end (surgical resection margin positivity) is staged pT3 and requires adjuvant chemotherapy to reduce systemic metastasis risk.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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