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 intrinsic muscles of tongue are four paired muscles within the tongue which control its shape. The extrinsic muscles originate from structures outside the tongue and control its positioning. **Note 4:** Assign T3 for localized tumor when no other information is available or for extension involving the mucosa only of adjacent sites. **Note 5:** Assign T4a or T4b for extension involving the deeper tissues of the primary or adjacent sites.


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 extension involving mucosa:
Anterior two-thirds of tongue for base of tongue
Base of tongue (posterior one-third of tongue):
Confined to one side
Midline tumor
Base of tongue for lingual tonsil
Epiglottis, lingual (pharyngeal) surface
Floor of mouth
Glossoepiglottic fold
Glossopharyngeal fold
Hard palate
Lateral pharyngeal wall
Lingual tonsil
Lower gingiva
Pharyngoepiglottic fold
Soft palate including uvula
Tonsillar pillars and fossae

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
Deep soft tissue or musculature of base of tongue or lingual tonsil
Soft tissue, NOS
Involvement of deep soft tissue or musculature of base of tongue or lingual tonsil plus mucosal involvement of any structure in T3
Sublingual gland

Deep soft tissue or musculature of soft palate, inferior surface or NOS, including uvula
Mandible for lingual tonsil
Mandible plus any involvement of soft palate
Mandible for base of tongue
Musculature, extrinsic of tongue:
Deep soft tissue or musculature of:

Bone excluding base of skull and mandible
Lateral nasopharynx
Pterygoid muscle
Pterygoid plates
Palatine bone

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
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.