Larynx - Glottic SCC: T Staging
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Hello everyone, Dr. Sidney Levy here, continuing our
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3 00:00:03,969 --> 00:00:06,250 discussion of the diagnosis and staging
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of laryngeal squamous cell malignancy.
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We've been using this example case of a
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large transglottic malignancy, which is
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centered at the level of the glottis.
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What constitutes T staging for glottic tumors?
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T1 tumor is limited to the vocal cords,
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including the anterior and posterior
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commissures, with normal cord mobility.
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T1a is one vocal cord involved.
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T1b is two vocal cords involved.
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We are way beyond that in this
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tumor, so that's not a consideration.
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Often T1 tumors are detected by the
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clinician, not by the radiologist.
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T2 tumors extend to the supraglottis or the subglottis,
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so they involve an adjacent subsite or both.
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And/or these tumors may demonstrate impaired cord
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mobility, which is a clinical finding essentially.
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Absolutely.
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T3 tumors are limited to the larynx with vocal
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cord fixation and/or invasion of the paraglottic
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space or the supraglottis and/or invasion of
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the inner cortex of the thyroid cartilage.
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So this tumor is involving both
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the inner and the outer cortex.
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So we are beyond T3.
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T4a tumor. T4b is moderately advanced local disease in
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which the tumor invades the outer cortex of the thyroid
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cartilage or tissues beyond the larynx, such as the
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trachea, the cricoid cartilage, or other soft tissues
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in the neck, such as extrinsic tongue musculature,
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strap muscles, the thyroid gland, or the esophagus. 5 00:00:09,130 --> 00:00:11,060 We've been using this example case of a
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large transglottic malignancy, which is
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centered at the level of the glottis.
0:16
What constitutes T staging for glottic tumors?
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T1 tumor is limited to the vocal cords,
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including the anterior and posterior
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commissures, with normal cord mobility.
0:28
T1a is one vocal cord involved.
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T1b is two vocal cords involved.
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We are way beyond that in this
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tumor, so that's not a consideration.
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Often T1 tumors are detected by the
0:42
clinician, not by the radiologist.
0:45
T2 tumors extend to the supraglottis or the subglottis,
0:50
so they involve an adjacent subsite or both.
0:55
And/or these tumors may demonstrate impaired cord
0:58
mobility, which is a clinical finding essentially.
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Absolutely.
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T3 tumors are limited to the larynx with vocal
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cord fixation and/or invasion of the paraglottic
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space or the supraglottis and/or invasion of
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the inner cortex of the thyroid cartilage.
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So this tumor is involving both
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the inner and the outer cortex.
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So we are beyond T3.
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T4a tumor. T4b is moderately advanced local disease in
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which the tumor invades the outer cortex of the thyroid
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cartilage or tissues beyond the larynx, such as the
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trachea, the cricoid cartilage, or other soft tissues
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in the neck, such as extrinsic tongue musculature,
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strap muscles, the thyroid gland, or the esophagus.
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T4b disease is very advanced local disease
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where the prevertebral space is involved.
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Or there is invasion of the mediastinum
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or encasement of the carotid artery.
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In our next vignette, we will discuss N staging
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of laryngeal and particularly glottic malignancies.
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Thank you.
Sidney Levy, PhD, MBBS
Radiologist and Nuclear Medicine Specialist
I-MED
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