Table 1. Primary Tumor (T)a,b
| All Uveal Melanomas | |
| TX | Primary tumor cannot be assessed. |
| T0 | No evidence of primary tumor. |
| Iris c | |
| T1 | Tumor limited to the iris. |
| T1a | Tumor limited to the iris not more than 3 clock hours in size. |
| T1b | Tumor limited to the iris more than 3 clock hours in size. |
| T1c | Tumor limited to the iris with secondary glaucoma. |
| T2 | Tumor confluent with or extending into the ciliary body, choroid, or both. |
| T2a | Tumor confluent with or extending into the ciliary body, choroid, or both, with secondary glaucoma. |
| T3 | Tumor confluent with or extending into the ciliary body, choroid, or both, with scleral extension. |
| T3a | Tumor confluent with or extending into the ciliary body, choroid, or both, with scleral extension and secondary glaucoma. |
| T4 | Tumor with extrascleral extension. |
| T4a | Tumor with extrascleral extension ≤5 mm in diameter. |
| T4b | Tumor with extrascleral extension >5 mm in diameter. |
| Ciliary Body and Choroidd | |
| T1 | Tumor size category 1. |
| T1a | Tumor size category 1 without ciliary body involvement and extraocular extension. |
| T1b | Tumor size category 1 with ciliary body involvement. |
| T1c | Tumor size category 1 without ciliary body involvement but with extraocular extension ≤5 mm in diameter. |
| T1d | Tumor size category 1 with ciliary body involvement and extraocular extension ≤5 mm in diameter. |
| T2 | Tumor size category 2. |
| T2a | Tumor size category 2 without ciliary body involvement and extraocular extension. |
| T2b | Tumor size category 2 with ciliary body involvement. |
| T2c | Tumor size category 2 without ciliary body involvement but with extraocular extension ≤5 mm in diameter. |
| T2d | Tumor size category 2 with ciliary body involvement and extraocular extension ≤5 mm in diameter. |
| T3 | Tumor size category 3. |
| T3a | Tumor size category 3 without ciliary body involvement and extraocular extension. |
| T3b | Tumor size category 3 with ciliary body involvement. |
| T3c | Tumor size category 3 without ciliary body involvement but with extraocular extension ≤5 mm in diameter. |
| T3d | Tumor size category 3 with ciliary body involvement and extraocular extension ≤5 mm in diameter. |
| T4 | Tumor size category 4. |
| T4a | Tumor size category 4 without ciliary body involvement and extraocular extension. |
| T4b | Tumor size category 4 with ciliary body involvement. |
| T4c | Tumor size category 4 without ciliary body involvement but with extraocular extension ≤5 mm in diameter. |
| T4d | Tumor size category 4 with ciliary body involvement and extraocular extension ≤5 mm in diameter. |
| T4e | Any tumor size category with extraocular extension >5 mm in diameter. |
| aReprinted with permission from AJCC: Malignant melanoma of the uvea. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 547-59. | |
| bThese definitions apply to both clinical and pathologic staging.[12] Note: In clinical practice, the largest tumor basal diameter may be estimated in optic disc diameters (dd, average: 1 dd = 1.5 mm). Tumor thickness may be estimated in diopters (average: 2.5 diopters = 1 mm). However, techniques such as ultrasonography and fundus photography are used to provide more accurate measurements. Ciliary body involvement can be evaluated by the slit-lamp, ophthalmoscopy, gonioscopy, and transillumination. However, high-frequency ultrasonography (ultrasound biomicroscopy) is used for more accurate assessment. Extension through the sclera is evaluated visually before and during surgery, and with ultrasonography, computed tomography, or magnetic resonance imaging. Note: When histopathologic measurements are recorded after fixation, tumor diameter and thickness may be underestimated because of tissue shrinkage. | |
| cIris melanomas originate from, and are predominantly located in, this region of the uvea. If less than half of the tumor volume is located within the iris, the tumor may have originated in the ciliary body and consideration should be given to classifying it accordingly. | |
| dPrimary ciliary body and choroidal melanomas are classified according to four tumor-size categories. |
References
- Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010.
