Which finding on staging imaging most accurately defines T3b stage in renal cell carcinoma according to TNM 8th edition?

• A Tumor extending into perinephric fat but confined within Gerota's fascia
• B Tumor extension into ipsilateral adrenal gland
• C Gross tumor thrombus extending into the renal vein or vena cava below the diaphragm ✓
• D Tumor thrombus in the vena cava above the diaphragm

Explanation

According to AJCC 8th edition TNM staging for renal cell carcinoma, T3b is defined as gross tumor extension into the renal vein or its segmental branches, or into the inferior vena cava below the level of the diaphragm. T3a includes perinephric fat invasion or adrenal gland direct extension; T3c denotes tumor thrombus extending into the vena cava above the diaphragm or involving the wall of the vena cava. T4 includes invasion beyond Gerota's fascia.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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