By Paul Hermanek, R.V.P. Hutter, L.H. Sobin, G. Wagner, C. Wittekind
The current variation of the TNM Atlas takes into account all additions and adjustments made within the 5th variation of the TNM class of Malignant Tumours and, for that reason, represents the present country of the TNM type as approved all over the world by means of all nationwide committees, together with the yank Joint Committee of melanoma. various illustrations facilitate the sensible program of the TMM process for all medical professionals operating within the box of oncology.
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Additional info for TNM Atlas: Illustrated Guide to the TNM/pTNM Classification of Malignant Tumours
16, 17) Tumour more than 4 cm in greatest dimension (Figs. iV; I I I I ...... ~.. --~ ........ "': . 15 pT2 ~ .. • ,;.. I " . " . g. through cortical bone, inferior alveolar nerve, floor of mouth, skin of face (Figs. g. through cortical bone, into deep (extrinsic) muscle of tongue, maxillary sinus, skin (Figs. 22-24) I. The extrinsic musculature of the tongue includes musculi hyo-, stylo-, genioand palatoglossus. Invasion of the intrinsic muscle alone (musculi longitudinales superior and inferior, transversus linguae and verticalis linguae) is not classified T4 (Pig.
Superficial erosion alone ofbone/tooth socket by gingival primary is not sufficient to classify a tumour as T4. 3. In cases of doubt regarding the invasion through cortical bone, such as that of Pig. 23a, paragraph 4 of the General Rules of the TNM System (TNM Booklet, p. less advanced) category should be chosen. This will also be reflected in the stage grouping". If scintigraphy is feasible and the resultant finding is conclusive as shown in Pig. 23b, the tumour must be classified as T4. ' ~ ~.
9): extends from the pharyngo-epiglottic fold to the upper end of the oesophagus. 1) and the arytenoid and cricoid cartilages 3. 2): extends from the superior level of the hyoid bone (or floor of the vallecula) to the level of the inferior border of the cricoid cartilage and from the apex of one piriform sinus to the other Regional Lymph Nodes See p. 7. 0 Pharynx 26 ----'' - -- - - ----- ~~ ~- -- TN Clinical Classification T - Primary Tumour TX TO Tis Primary tumour cannot be assessed No evidence of primary tumour Carcinoma in situ Oropharynx Tl T2 Tumour 2 cm or less in greatest dimension (Fig.