6th AJCC StagingAJCC Staging Oropharynx · SCCSCC O C y O p yA of the Oral Cavity and the...
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SCCA of the Oral Cavity and the Oropharynx: How Imaging Can Make a Difference Suresh K. Mukherji, M.D., F.A.C.R. Professor and Chief of Neuroradiology Professor and Chief of Neuroradiology Professor of Radiology, Otolaryngology, Radiation Oncology, Periodontics and Oral Medicine Periodontics and Oral Medicine University of Michigan Health System 6 th AJCC Staging 6 AJCC Staging Oropharynx Tis: Carcinoma in situ T1: Tumor < 2 cm in greatest dimension T2: Tumor 2 < 4 cm in greatest diameter T3: Tumor > 4 cm in greatest dimension T3: Tumor > 4 cm in greatest dimension T4: a Invasion of larynx deep/extrinsic muscle of a. Invasion of larynx, deep/extrinsic muscle of tongue, medial pterygoid, hard palate or mandible b. Invasion of lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases the carotid artery
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Transcript of 6th AJCC StagingAJCC Staging Oropharynx · SCCSCC O C y O p yA of the Oral Cavity and the...
SCCA of the Oral Cavity and the Oropharynx:SCC O C y O p yHow Imaging Can Make a Difference
Suresh K. Mukherji, M.D., F.A.C.R.Professor and Chief of NeuroradiologyProfessor and Chief of Neuroradiology
Professor of Radiology, Otolaryngology, Radiation Oncology, Periodontics and Oral MedicinePeriodontics and Oral Medicine
University of Michigan Health System
6th AJCC Staging6 AJCC StagingOropharynx
Tis: Carcinoma in situT1: Tumor < 2 cm in greatest dimensionu o c g eatest d e s oT2: Tumor 2 < 4 cm in greatest diameterT3: Tumor > 4 cm in greatest dimensionT3: Tumor > 4 cm in greatest dimension T4:
a Invasion of larynx deep/extrinsic muscle ofa. Invasion of larynx, deep/extrinsic muscle of tongue, medial pterygoid, hard palate or mandible
b. Invasion of lateral pterygoid muscle, pterygoid p yg , p ygplates, lateral nasopharynx, or skull base or encases the carotid artery
OropharynxOropharynx
Tongue Base
Tongue BaseTongue Base
Tongue BaseTongue Base
Orophar nOropharynx
Tongue Base
Tonsil
Anatomy:y“Tonsil”
TonsilTonsil
TonsilTonsil
OropharynxOropharynx
Tongue Base
Tonsil
Soft PalateSoft Palate
S ft P l tSoft Palate
S ft P l tSoft Palate
S ft P l tSoft Palate
R t h l L h N dRetropharyngeal Lymph Nodes
Retropharyngeal Lymph NodesRetropharyngeal Lymph Nodes
O liOutline
• Oropharynx
• Oral Cavity
AJCC/UICC Stagingg gOral Cavity
Tis: Carcinoma in situT1: Tumor < 2 cm in greatest dimensionT1: Tumor < 2 cm in greatest dimensionT2: Tumor 2 < 4 cm in greatest diameterT3: Tumor > 4 cm in greatest dimensionT3: Tumor > 4 cm in greatest dimensionT4:
a. Invasion through cortical bone, into deep extrinsica. Invasion through cortical bone, into deep extrinsic muscles of tongue, maxillary sinus, or skin of face
b. Invasion of masticator space, pterygoid plates, or skull base and/or encases internal carotid arteryskull base and/or encases internal carotid artery
O l C itOral Cavity
Buccal
B lBuccal
B lBuccal
O l C itOral Cavity
Buccal Space
Oral Tongue (“Mobile Tongue”)
Anatomy:y“Oral Tongue, MobileTongue”
O l TOral Tongue
“Wide Local Excision”
Crosses Midline
Deep Extension (Hyoglossus muscle): T4p ( y g )
Marginal (Rim) Mandibulectomyg ( ) y
T4: Deep Extension: Extrinsic Tongue Musclesp g
Hyoglossusy g
GenioglossusGenioglossus
O l C itOral Cavity
Buccal
Oral Tongue (“Mobile Tongue”)
Floor of Mouth (Sublingual Space)
Anatomy:y“Floor of Mouth, Sublingual Space”
Floor of MouthFloor of Mouth
Fl f M thFloor of Mouth
Fl f M thFloor of Mouth
O l C itOral Cavity
Buccal
Oral Tongue (“Mobile Tongue”)
Floor of Mouth (Sublingual Space)
Retromolar TrigoneRetromolar Trigone
Anatomy:Anatomy:“Retromolar Trigone”
R t l T iRetromolar Trigone
Anatomy:Anatomy:“Retromolar Trigone”
O l C itOral Cavity
Buccal
Oral Tongue (“Mobile Tongue”)
Floor of Mouth (Sublingual Space)
Retromolar TrigoneRetromolar Trigone
Hard Palate
Anatomy:yHard Palate
Hard PalateHard Palate
H d P l tHard Palate
Hard PalateHard Palate
Hard PalateHard Palate
Hard PalateHard Palate
Hard PalateHard Palate
SSummary
• Oropharynx
• Oral Cavity
