Sinonasal mucosal melanoma staging

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 8 edition manual published by the American Joint Committee on Cancer, which is used for staging starting January 1, 2018 .

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
• 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
  • T4b: very advanced local disease in which tumor involves any of the following:
    • dura
    • brain
    • skull base
    • lower cranial nerves (IX, X, XI, XII)
    • masticator space
    • carotid artery
    • prevertebral space
    • mediastinal structures

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

• stage III
  • T3, N0, M0
• stage IVA
  • T4a, N0, M0
  • [T3, T4a], N1, M0
• stage IVB
  • T4b, [Any N], M0
• stage IVC
  • [Any T], [Any N], M1

See also

• WHO classification of head and neck tumors