This reference uses AJCC 8, confirmed current for this site on 4 November 2026. UICC TNM 9th edition, effective in 2026, is a separate system. Record organisation, edition, anatomical location and the c/p/yc/yp prefix. AJCC · UICC.
AJCC 8 provides an anatomically specific TNM for head and neck mucosal melanoma. Anorectal, vulvovaginal, urethral and other mucosal sites require separate descriptions and interpretation; do not substitute cutaneous AJCC 8 melanoma staging.
Head and neck: AJCC 8 T3, T4a and T4b
| Category | Extent | Clinical explanation |
|---|---|---|
| T3 | Confined to epithelium and/or submucosa | AJCC mucosal H&N begins at T3 and does not use Breslow thickness as the T criterion. |
| T4a | Deep soft tissue, cartilage, bone or overlying skin | Moderately advanced local tumour. |
| T4b | Skull base, brain, dura, lower cranial nerves IX-XII, masticator/prevertebral space, carotid artery or mediastinal structures | Very advanced local disease. |
| N0 / N1 | No / yes regional lymph-node involvement | Not the cutaneous melanoma N1a/b/c scheme. |
| M0 / M1 | No / yes distant metastasis | Document disease extent with appropriate imaging. |
Head-and-neck mucosal melanoma has AJCC 8 TNM categories but no prognostic stage-group assignment. Legacy stage III/IVA/IVB/IVC groupings from AJCC 7 must not be presented as AJCC 8 stage groups.
Primary-site differences
MDT review requirements
Appropriate melanocytic IHC and exclusion of mimics.
MRI/CT, bone or deeper invasion, operability, functional effects and regional nodes.
KIT, NRAS, BRAF and other indicated alterations; predictive findings are not stage groups.
Primary references
WHO update and AJCC 8 head/neck mucosal melanoma; ICCR reporting dataset; AJCC current version list.
Other staging systems
Educational reference, not a substitute for specialist MDT review or official AJCC protocols. Record the edition used and do not infer a stage group from a single image.