Scenario: 65 year old male presents to your facility for resection of a Goiter, US shows: 1.5cm nodule right lobe of the thyroid, physical exam reveals 1.5cm thyroid nodule, no apparent adenopathy in neck. Path report from thyroidectomy: 1.5cm papillary carcinoma limited to right lobe of thyroid.
Question: What is the clinical stage?
- cT1b(s) cN0 cM0 Stage 1
- cT (blank) cN (blank) cM (Blank) Stage 99
Answer: cT (blank) cN (blank) cM (Blank) Stage 99Tis
- AJCC 8th Edition Chapter 73 Thyroid Rules for Clinical Classification: Fine needle aspiration of suspicious thyroid nodules and/or abnormal-appearing lymph nodes should be undertaken preoperatively to obtain a definitive diagnosis and allow for appropriate surgical planning… Although a highly suspicious ultrasound pattern carries a >70– 90% likelihood that thyroid cancer is present, cytologic or histologic proof of disease is required before staging.
- AJCC 8th Edition Chapter 1 Tumor must be known or suspected and have a diagnostic workup including at least a history and physical examination to assign a clinical stage. Incidental findings at the time of surgical treatment may not be assigned a clinical stage retrospectively.
- CAnswer Forum Post. Thyroid cancer must be microscopically confirmed in order to make the diagnosis. Without a diagnosis, you cannot assign the clinical stage. http://cancerbulletin.facs.org/forums/forum/ajcc-tnm-staging-8th-edition/endocrine-system-chapters-73-77/thyroid-differentiated-and-anaplastic-carcinoma-chapter-73/87902-clinical-stage-blank-without-cytologic-or-histologic-proof-of-disease
TIP: Don’t forget to assign the AJCC T Suffix for those Thyroid Cases.
- (s) Solitary tumor (differentiated and anaplastic thyroid only)
- (m) Multifocal tumor (differentiated and anaplastic thyroid only)