Tumor Tip of the Week 03-15-2024 Melanoma pT1 cN0 - Omega Healthcare

Tumor Tip of the Week 03-15-2024 Melanoma pT1 cN0

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03-15-2024 Melanoma pT1 cN0


  • [Physical exam showed no lymphadenopathy], patient dx on Shave biopsy, went on to have Wide excision
  • Snip from Path Report from Wide Excision
    • Tumor Site                        Skin of trunk
    • Histologic Type               Melanoma, NOS
    • (Breslow) Thickness      0.2mm (residual) mm
    • Ulceration                         Not identified
    • Anatomic (Clark) Level               II
    • Regional Lymph Node Status                Not applicable (no regional lymph nodes submitted or found)
    • pT Category                     pT1a
    • pN Category                    pN not assigned (no nodes submitted or found)

Question:  How would you assign Pathologic N category?

  • pNX
  • cN0
  • pN BLANK

Answer:  cN0

Rationale: This case does meet the eligibility criteria for pathologic staging-the primary site was resected, but no nodes were removed.  In this instance instead of assigning a pNX we can assign a cN0.  There are certain site/histology combinations/situations when you can assign a cN0 in the path N category. This is one of those situations, for Melanoma pT1 cases can be assigned a cN0.  For a complete list of Sites where Node Status Not required in Rare Circumstances refer to the AJCC Registrar Education refer to Critical Clarifications Document entitled Node Status  & AJCC 8th Edition Melanoma Staging https://www.facs.org/quality-programs/cancer-programs/american-joint-committee-on-cancer/staging-education/registrar/

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