Pathologic T

This input is used for staging


**Note 1:** Assign 88 for in situ cases (behavior code /2). TNM does not include an in situ category for mucosal melanoma tumors. **Note 2:** Mucosal melanomas are aggressive tumors, therefore, T1 and T2 are omitted, as are Stages I and II. **Note 3:** The bones of the lateral wall of the nasal cavity include the maxilla, the perpendicular plate of the palatine bone, the medial pterygoid plate, the labyrinth and inferior concha of the ethmoid. The roof of the nasal cavity is formed by the nasal bone. The floor of the nasal cavity, which forms the roof of the mouth, is composed of the bones of the hard palate: the horizontal plate of the palatine bone posteriorly and the palatine process of the maxilla anteriorly. **Note 4:** "Bony invasion" does not include extension to palate, cribriform plate, or pterygoid plates. Extension to these structures is coded separately.


Pathologic T Pathologic T Display Description Registrar Notes
pX pTX Primary tumor cannot be assessed# Pathologic classification criteria met, evaluation done:
Physician unable to assess T
Surgical resection of primary tumor, extension not stated
Physician assigns pTX, no other information available to determine T
p0 pT0 No evidence of primary tumor#
p3 pT3 Tumor limited to the epithelium and/or submucosa (mucosal disease) Tumor confined to mucosa of one of the following subsites:
Lateral wall, including:
Meatus (superior, middle, inferior)
Nasal conchae (superior, middle, inferior)
Vestibule (edge of naris to mucocutaneous junction)

Confined to mucosa of nasal cavity, NOS

Extension involving mucosa only:
Ethmoid sinus
Frontal sinus
Maxillary sinus
Sphenoid sinus

Localized, NOS

Stated as T3
p4 pT4 Not defined by UICC*# Note: T4 has subcategories of T4a and T4b. Assign T4 only when there is no information available to assign one of the subcategories

Tumor invades bone, nerve or extrinsic deep muscles

Stated as T4[NOS]
p4A pT4a Tumor invades:
Deep soft tissue
Overlying skin
Involvement of deep tissues of any structure in T3
Involvement of any structure in code T3 WITH bony invasion
Extending to adjacent connective tissue within the nasoethomoidal complex
Anterior orbital contents
Hard palate
Medial wall or floor of the orbit
Nasolacrimal duct
Pterygoid plates
Skin of nose
Skin of cheek

Stated as T4a
p4B pT4b Tumor invades any of the following:
Skull base
Lower cranial nerves (IX, X, XI, XII)
Masticator space
Carotid artery
Prevertebral space
Mediastinal structures
Anterior cranial fossa
Base of skull
Cribriform plate
Middle cranial fossa

Stated as T4b
88 88 Not applicable In situ case but no pTis is defined by TNM
Death certificate only (DCO) case
<BLANK> BLANK See Registrar Notes Pathologic classification criteria not met
Pathologic classification criteria met, evaluation done:
Results not documented in patient record
No surgical resection of known primary tumor (not T0)
Resection insufficient for site-specific pathologic assessment
No surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category
Evidence of metastatic disease (pM1), no other workup
Only Pathologic Stage Group documented (no T, N, or M information available)
\* T4 [NOS] is not defined by UICC in the 7th edition. Approval has been provided by UICC to use "Tumor invades bone, nerve or extrinsic deep muscles" as T4 [NOS]. \# TX, T0 and T4 [NOS] are not defined in AJCC 7th edition.