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T4: Invasion into ipsilateral adrenal gland
T4a (Lip) is defined as moderately advanced local disease, tumor invading through cortical bone, inferior alveolar nerve, floor of mouth, or skin of face, i
T4a for the supraglottis is defined as moderately advanced local disease, tumor invading through the thyroid cartilage and/or invading tissues beyond the larynx (e
T4a in the nasal cavity and ethmoid sinus is moderately advanced local disease, and invades any of the following: anterior orbital contents, skin of nose or cheek, minimal extension to anterior cranial fossa, pterygoid plates, sphenoid, or frontal sinuses
T4a is defined as gross extrathyroidal extension invading subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve from a tumor of any size
T4a is defined as moderately advanced disease, with tumor involving deep soft tissue, cartilage, bone, or overlying skin
T4a is defined as moderately advanced disease; tumor of any size with gross extrathyroidal extension into the nearby tissues of the neck, including subcutaneous soft tissue, larynx, trachea, esophagus, or recurrent laryngeal nerve
T4a is defined as moderately advanced local disease, tumor invading adjacent structures only (e
T4a is defined as tumor that penetrates the serosa (visceral peritoneum) without invasion of adjacent structures
T4a is defined as tumor that penetrates the serosa (visceral peritoneum) without invasion of adjacent structures, whereas T4b is defined as tumor that radially invades adjacent structures, shown here invading the pancreas
T4a melanoma
T4a tumor of the hypopharynx that is moderately advanced local disease, with invasion of the hyoid bone, thyroid/cricoid cartilage, thyroid gland, or central compartment soft tissue
T4a tumor of the oropharynx is described as moderately advanced local disease, a tumor that invades the larynx, extrinsic muscle or tongue, medial pterygoid, hard palate, or mandible
T4a tumors of the glottis are moderately advanced local disease, and invade through the outer cortex of the thyroid cartilage and/or invade tissues beyond the larynx (e
T4a tumors of the subglottis are moderately advanced local disease, and invade cricoid or thyroid cartilage and/or invade tissues beyond the larynx (e
T4b is defined as gross extrathyroidal extension invading prevertebral fascia or encasing the carotid artery or mediastinal vessels from a tumor of any size
T4b is defined as very advanced disease, with tumor involving the brain as illustrated, or also involving dura, lower cranial nerves (IX, X, XI, XII), masticator space, carotid artery, prevertebral space, or mediastinal structures
T4b is defined as very advanced disease; tumor of any size with extension toward the spine or into nearby large blood vessels, invading the prevertebral fascia, or encasing the carotid artery or mediastinal vessels
T4b is defined as very advanced local disease, tumor involves masticator space, pterygoid plates (as shown), or skull base and/or encases internal carotid artery
T4b melanoma
T4b tumor of the oropharynx is a tumor described as very advanced local disease, a tumor that invades lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery
T4b tumor the hypopharynx that is very advanced local disease, with invasion of the prevertebral fascia, encases carotid artery, or involves mediastinal structures
T4 for leiomyosarcoma, endometrial stromal sarcoma, and adenosarcoma is tumor invades bladder or rectum
T4 is defined as a primary tumor invading fascia, muscle, cartilage, or bone
T4 is defined as tumor greater than 7 cm or tumor of any size invading one or more of the following: diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or carina; separate tumor nodule(s) in an ipsilateral lobe different from that of the primary
T4 is defined as tumor of any size that invades adjacent organs (kidney, diaphragm, pancreas, spleen, or liver) or large blood vessels (renal vein or vena cava)
T4 is defined as tumor that invades into adjacent structures such as scrotum, prostate, pubic bone (shown here)
T4 is defined as tumor that invades other adjacent organs (invasion of the bladder is illustrated)
T4 is locally advanced, technically unresectable tumor
T4 is tumor invading mucosa of bladder or rectum, and/or extends beyond true pelvis (bullous edema is not sufficient to classify a tumor as T4)
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