A 70-year-old man presents with a 2 cm ulcerated anal margin lesion. Biopsy shows squamous cell carcinoma. There is a single ipsilateral inguinal lymph node palpable, 2 cm, confirmed malignant on FNAC. What is the TNM stage (AJCC 8th edition)?
- A T2 N2 M0 (Stage IIIB)
- B T2 N1 M0 (Stage IIIA) ✓
- C T1 N1 M0 (Stage IIIA)
- D T2 N1 M0 (Stage IIIC)
Correct answer: B. T2 N1 M0 (Stage IIIA)
Explanation
Anal canal SCC staging (AJCC 8th): T2 is tumour greater than 2 cm but not more than 5 cm. N1 is metastasis in inguinal, mesorectal, or internal iliac nodes. B single ipsilateral inguinal node is N1. Stage IIIA is T1-2 N1 M0. N2 requires multiple or bilateral nodes (Stage IIIB). Anal margin SCC uses skin cancer staging but the principle of single regional node as N1 applies.
Reference: AJCC Cancer Staging Manual, 8th ed.
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