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Skin Cancer Staging, MCSCC, Merkel Cell - Coggle Diagram

- - - - Deep invasion is defined as invasion beyond the subcutaneous fat or >6 mm
        (as measured from the granular layer of adjacent normal epidermis to the
        base of the tumor)
      - T4
        T4a. gross cortical bone/marrow invasion :meat_on_bone:
        T4b. skull base invasion :skull: or skull base foramen involvement
  - - - N3
        N3a. +6cm
        N3b. ENE+ :egg:
        
        pN3b: + 3cm single ipsi AND ENE+;
        -OR-
        multiple ipsilateral, contralateral, or bilateral nodes, any with ENE(+)
        -OR-
        or a single contralateral node of any size and ENE(+)
        
        designation of “U” or “L” may be used for any N category to indicate metastasis above the lower border of
        the cricoid (U) or below the lower border of the cricoid (L)
      - pN2a. ≤ 3cm single ipsi AND ENE+
- - - - T4
        Invasion :alien:: fascia, cartilage, muscle :muscle::skin-tone-3:, :meat_on_bone: bone
  - - - N3
        c/pN3: ITM w/ LN metastasis.
      - in-transit metastasis discontinuous from primary tumor, located between primary tumor and draining LN basin),