Welcome to your Oral Cancer TNM Staging (AJCC 8th Edition) Scenario-Based MCQs
1.
A patient with oral tongue SCC has three ipsilateral cervical lymph nodes, the largest measuring 4 cm, with no extranodal extension. The correct clinical N classification is:
2.
A 64-year-old patient has carcinoma of the buccal mucosa measuring 3.5 cm. Histopathology shows a depth of invasion of 12 mm. There is no invasion of adjacent structures. What is the appropriate T category?
3.
A 61-year-old smoker is diagnosed with squamous cell carcinoma of the floor of the mouth. The lesion measures 1.9 cm, but MRI demonstrates a depth of invasion of 8 mm. There is no nodal or distant metastasis. What is the correct T stage?
4.
A 52-year-old man presents with a painless ulcer on the lateral border of the tongue. MRI reveals a lesion measuring 1.6 cm in greatest dimension with a depth of invasion (DOI) of 3 mm. There is no cervical lymphadenopathy or distant metastasis. What is the correct T classification?
5.
A 60-year-old woman has a 1.8-cm carcinoma of the floor of the mouth. Histopathology reports a depth of invasion of 8 mm. Which T stage is most appropriate?
6.
A patient presents with a T1 squamous cell carcinoma of the tongue, N2b cervical disease, and no distant metastasis. What is the overall prognostic stage?
7.
A carcinoma of the mandibular gingiva has invaded the cortical bone of the mandible on CT scan. Which T stage is correct?
8.
A 59-year-old man has a 3-cm carcinoma of the mandibular gingiva. CT scan demonstrates invasion through the cortical bone of the mandible. No skull base involvement is present. Which is the correct T stage?
9.
A patient with carcinoma of the retromolar trigone is found on MRI to have tumor extension into the masticator space. The tumor should be staged as:
10.
A patient has a 5-cm carcinoma of the tongue with DOI of 8 mm. No bone invasion is present. What is the T stage?
11.
Following neoadjuvant chemoradiotherapy for oral cavity SCC, a patient undergoes surgical resection. The pathology report is used to determine the final post-treatment stage. Which TNM prefix should be applied?
12.
A patient with oral squamous cell carcinoma demonstrates tumor extension into the maxillary sinus. The appropriate T classification is:
13.
MRI shows a tongue carcinoma extending into the masticator space. What is the correct T stage?
14.
A patient with carcinoma of the tongue has bilateral cervical lymph node metastases, with the largest node measuring 5 cm and no extranodal extension. Which clinical N category is correct?
15.
A patient has a 3.2-cm squamous cell carcinoma of the buccal mucosa with DOI 9 mm. What is the T category?
16.
A patient undergoes neck dissection for oral SCC. Histopathology reveals a single ipsilateral metastatic lymph node measuring 2.7 cm with microscopic extranodal extension. Which pathological N category is correct?
17.
A patient with oral squamous cell carcinoma undergoes sentinel lymph node biopsy. A single metastatic lymph node is identified only by sentinel node biopsy, with no additional nodal disease. Which suffix should accompany the N category?
18.
A patient with oral SCC has a single ipsilateral cervical lymph node measuring 2.4 cm. Imaging shows no extranodal extension (ENE−). Which clinical N stage is correct?
19.
A 70-year-old patient has a T2 oral tongue SCC, a single ipsilateral 2.5-cm ENE-negative cervical node, and no distant metastasis. According to the AJCC 8th edition prognostic stage grouping, the disease is:
20.
A patient with oral tongue carcinoma has a single ipsilateral cervical lymph node measuring 2.8 cm. Radiologic assessment demonstrates clinically overt extranodal extension (ENE+). What is the correct clinical N stage?
21.
A 65-year-old man has a 3.5-cm tongue carcinoma with DOI 12 mm. No adjacent structures are invaded. What is the T stage?
22.
A 67-year-old man has oral cavity SCC with four ipsilateral metastatic cervical lymph nodes, the largest measuring 5 cm. None demonstrate extranodal extension. What is the correct clinical N classification?
23.
A 59-year-old man presents with a squamous cell carcinoma of the lateral tongue measuring 2.1 cm in greatest dimension. MRI demonstrates a depth of invasion (DOI) of 4 mm. There is no cervical lymphadenopathy or distant metastasis. What is the most appropriate AJCC 8th edition T classification?
24.
A 58-year-old woman with tongue carcinoma has a single ipsilateral cervical lymph node measuring 2.5 cm. Imaging shows no extranodal extension (ENE−). What is the correct clinical N stage?
25.
A 63-year-old woman has a 1.9-cm floor-of-mouth squamous cell carcinoma with 11-mm DOI. CT scan shows no invasion of adjacent structures. There are no cervical lymph nodes or distant metastases. What is the primary tumor stage?
26.
A patient with carcinoma of the buccal mucosa has bilateral cervical lymph node metastases, each measuring 4 cm, with no clinical evidence of extranodal extension. Which clinical nodal stage is most appropriate?
27.
A 56-year-old man presents with a non-healing ulcer on the lateral border of the tongue. MRI shows a lesion measuring 1.8 cm in greatest dimension with a depth of invasion (DOI) of 4 mm. There is no evidence of cervical lymph node involvement or distant metastasis. The primary tumor should be classified as:
28.
A 63-year-old man has oral tongue carcinoma with one ipsilateral cervical lymph node measuring 4 cm. Imaging demonstrates no extranodal extension (ENE−). What is the clinical N classification?
