Evaluation of suspected malignancies

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Author: Mikael Häggström [note 1]

General notes edit

Further reading:


The primary focus of tumor evaluation is to distinguish benign from malignant types, and in case of malignancy the primary focus is to determine its stage, generally by the TNM classification:[1] T: size or direct extent of the primary tumor

    • Tx: tumor cannot be assessed
    • Tis: carcinoma in situ
    • T0: no evidence of tumor
    • T1, T2, T3, T4: size and/or extension of the primary tumor

N: degree of spread to regional lymph nodes

    • Nx: lymph nodes cannot be assessed
    • N0: no regional lymph node metastasis
    • N1: regional lymph node metastasis present; at some sites, tumor spread to closest or small number of regional lymph nodes
    • N2: tumor spread to an extent between N1 and N3 (N2 is not used at all sites)
    • N3: tumor spread to more distant or numerous regional lymph nodes (N3 is not used at all sites)

M: presence of distant metastasis

    • M0: no distant metastasis
    • M1: metastasis to distant organs (beyond regional lymph nodes)

Beyond the above mentioned, specific histopathologies of tumors is generally of relatively little value. Thus, in cases where it is difficult to determine whether it is one type of non-malignant histopathologic type or another non-malignant type, it is generally acceptable to conclude the evaluation and report it as such, unless the clinician specifically requests otherwise.


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  1. . Cancer staging. National Cancer Institute. Retrieved on 4 January 2013.

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