Mucosal melanoma of the head and neck staging refers to TNM staging of mucosal melanoma involving the nasal cavity, paranasal sinuses, oral cavity, and, less commonly, pharynx and larynx. The system is distinct from staging of carcinomas of those sites and of cutaneous melanoma. The following article reflects the 8th edition manual published by the American Joint Committee on Cancer, which is used for staging starting January 1, 2018 1,2.
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Primary tumor (T)
T1 and T2 categories are omitted due to the poor prognosis of even small and superficial lesions.
T3: tumor is limited to mucosa and immediately underlying soft tissue
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T4: moderately advanced or very advanced local disease
T4a: moderately advanced local disease in which tumor involves deep soft tissue, cartilage, bone, or overlying skin
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T4b: very advanced local disease in which tumor involves any of the following:
Regional lymph node (N)
NX: regional lymph nodes cannot be assessed
N0: no regional lymph node metastases
N1: regional lymph node metastases present
Distant metastases (M)
The terms pM0 and MX are not valid TNM categories. The following categories may be used:
cM0: no evidence of metastases
cM1: distant metastasis
pM1: distant metastasis, microscopically confirmed
Stage groups
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stage III
T3, N0, M0
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stage IVA
T4a, N0, M0
[T3, T4a], N1, M0
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stage IVB
T4b, [Any N], M0
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stage IVC
[Any T], [Any N], M1