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Question 1Head and Neck Anatomy and Tumor Biology

Which cranial nerve provides motor innervation to the muscles of mastication?

  1. Trigeminal nerve (CN V3) Correct answer.
  2. Glossopharyngeal nerve (CN IX)
  3. Hypoglossal nerve (CN XII)
  4. Facial nerve (CN VII)

Explanation

The mandibular division of the trigeminal nerve supplies motor fibers to the masseter, temporalis, and medial and lateral pterygoids. These are the primary muscles that move the mandible during chewing.

Question 2Head and Neck Anatomy and Tumor Biology

The lymphatic drainage of the oral tongue most commonly first reaches which nodal group?

  1. Submandibular and upper jugular nodes Correct answer.
  2. Submental nodes
  3. Supraclavicular nodes
  4. Retropharyngeal nodes

Explanation

The oral tongue drains primarily to submandibular and upper deep cervical (level I-II) nodes because of its rich bilateral lymphatic supply. This pattern explains the frequency of level I-II metastases in tongue cancer.

Question 3Head and Neck Anatomy and Tumor Biology

Which structure passes through the foramen ovale?

  1. Internal carotid artery
  2. Middle meningeal artery
  3. Mandibular division of the trigeminal nerve Correct answer.
  4. Maxillary division of the trigeminal nerve

Explanation

The foramen ovale transmits the mandibular division (V3) of the trigeminal nerve along with the lesser petrosal nerve. The maxillary division exits through the foramen rotundum.

Question 4Head and Neck Anatomy and Tumor Biology

The vocal folds are attached anteriorly to which laryngeal structure?

  1. Cricoid cartilage
  2. Thyroid cartilage Correct answer.
  3. Arytenoid cartilage
  4. Epiglottis

Explanation

The true vocal folds attach anteriorly to the inner angle of the thyroid cartilage and posteriorly to the arytenoid cartilages. This arrangement allows tension changes during phonation.

Question 5Head and Neck Anatomy and Tumor Biology

Which salivary gland is the most common site of salivary gland malignancy?

  1. Sublingual gland
  2. Submandibular gland
  3. Minor salivary glands Correct answer.
  4. Parotid gland

Explanation

Although the parotid hosts most salivary tumors overall, malignancies are proportionally most frequent in the minor salivary glands and sublingual gland. Minor salivary gland tumors carry a high malignant fraction.

Question 6Head and Neck Anatomy and Tumor Biology

The blood supply to the anterior two-thirds of the nasal septum is primarily from which artery?

  1. Facial artery
  2. Anterior ethmoidal artery
  3. Sphenopalatine artery Correct answer.
  4. Greater palatine artery

Explanation

Kiesselbach's plexus on the anterior septum is dominated by the sphenopalatine artery, with contributions from anterior ethmoidal, greater palatine, and septal branches of the facial artery. The sphenopalatine is the largest contributor.

Question 7Head and Neck Anatomy and Tumor Biology

Which paranasal sinus drains into the middle meatus of the nasal cavity?

  1. Posterior ethmoidal air cells
  2. Frontal sinus only via the inferior meatus
  3. Sphenoid sinus
  4. Maxillary sinus Correct answer.

Explanation

The maxillary sinus drains through its ostium into the hiatus semilunaris of the middle meatus. Frontal and anterior ethmoidal sinuses also drain into the middle meatus.

Question 8Head and Neck Anatomy and Tumor Biology

A tumor arising in the nasopharynx most commonly spreads first to which nodal region?

  1. Level I submental nodes
  2. Level VI pretracheal nodes
  3. Retropharyngeal and level II nodes Correct answer.
  4. Parotid intraparotid nodes

Explanation

Nasopharyngeal carcinoma has a strong predilection for retropharyngeal and upper jugular (level II) nodes because of the dense submucosal lymphatics of the fossa of Rosenmüller. Bilateral involvement is common.

Question 9Head and Neck Anatomy and Tumor Biology

Which muscle elevates the soft palate during swallowing?

  1. Palatopharyngeus
  2. Tensor veli palatini
  3. Palatoglossus
  4. Levator veli palatini Correct answer.

Explanation

The levator veli palatini, innervated by the pharyngeal plexus (CN X), is the principal elevator of the soft palate. It lifts the palate to close the nasopharynx during swallowing.

Question 10Head and Neck Anatomy and Tumor Biology

Which feature best distinguishes a benign pleomorphic adenoma from a malignant salivary tumor on histology?

  1. Presence of keratin pearls
  2. Presence of a well-defined capsule and biphasic epithelial-myxochondroid pattern Correct answer.
  3. High mitotic rate with necrosis
  4. Perineural invasion with cribriform architecture

Explanation

Pleomorphic adenoma shows a well-defined capsule and a biphasic mix of epithelial and myxochondroid stroma. Malignant tumors more often show infiltrative borders, perineural invasion, and cytologic atypia.

Question 11Head and Neck Anatomy and Tumor Biology

The pterygopalatine fossa communicates with the infratemporal fossa through which opening?

  1. Foramen rotundum
  2. Sphenopalatine foramen
  3. Inferior orbital fissure
  4. Pterygomaxillary fissure Correct answer.

Explanation

The pterygomaxillary fissure connects the pterygopalatine fossa laterally with the infratemporal fossa. This route allows spread of tumor or infection between the two spaces.

Question 12Head and Neck Anatomy and Tumor Biology

A patient has a tumor at the jugular foramen. Which combination of deficits is most consistent with this location?

  1. Loss of smell and vision
  2. Tongue deviation and hearing loss
  3. Facial numbness and jaw deviation
  4. Hoarseness, dysphagia, and shoulder weakness Correct answer.

Explanation

The jugular foramen transmits CN IX, X, and XI, so lesions cause dysphagia, hoarseness, and sternocleidomastoid or trapezius weakness. Glomus jugulare tumors and schwannomas classically present this way.

Question 13Head and Neck Anatomy and Tumor Biology

Which statement best describes the field cancerization concept in head and neck squamous cell carcinoma?

  1. A single clone metastasizes to multiple nodal levels
  2. Tumors arise only from a single transformed stem cell
  3. Distant metastases precede nodal spread
  4. Genetic alterations accumulate across the entire aerodigestive mucosa Correct answer.

Explanation

Field cancerization holds that carcinogen exposure produces genetically altered mucosa beyond the visible tumor, raising the risk of synchronous and metachronous primaries. This explains second primary tumors in the aerodigestive tract.

Question 14Head and Neck Anatomy and Tumor Biology

HPV-positive oropharyngeal squamous cell carcinoma typically shows which molecular feature?

  1. TP53 point mutations as the dominant driver
  2. Inactivation of p53 by viral E6 protein Correct answer.
  3. Loss of RB through chromosomal deletion
  4. Amplification of EGFR as the primary event

Explanation

In HPV-driven oropharyngeal cancer, viral E6 degrades p53 and E7 inactivates RB, producing a distinct molecular profile. These tumors usually lack the TP53 mutations typical of tobacco-related cancers.

Question 15Head and Neck Anatomy and Tumor Biology

Which nerve is at greatest risk during ligation of the inferior thyroid artery?

  1. Hypoglossal nerve
  2. Superior laryngeal nerve
  3. Accessory nerve
  4. Recurrent laryngeal nerve Correct answer.

Explanation

The recurrent laryngeal nerve runs close to the inferior thyroid artery and is vulnerable during its ligation. Injury causes vocal fold paresis and hoarseness.

Question 16Head and Neck Anatomy and Tumor Biology

Which receptor tyrosine kinase pathway is most commonly dysregulated in head and neck squamous cell carcinoma?

  1. HER2
  2. ALK
  3. EGFR Correct answer.
  4. BRAF

Explanation

EGFR is overexpressed or amplified in most head and neck squamous cell carcinomas and drives proliferation through the RAS-MAPK and PI3K pathways. Cetuximab targets this receptor.

Question 17Head and Neck Anatomy and Tumor Biology

A tumor of the parapharyngeal space characteristically displaces the parapharyngeal fat in which direction when it arises from the deep lobe of the parotid?

  1. Superiorly into the orbit
  2. Inferiorly into the mediastinum
  3. Posterolaterally
  4. Anteromedially Correct answer.

Explanation

Deep lobe parotid tumors lie in the prestyloid compartment and push the parapharyngeal fat anteromedially. This displacement pattern helps distinguish them from post-styloid lesions.

Question 18Head and Neck Anatomy and Tumor Biology

Which structure separates the parotid gland from the submandibular gland along the mandible?

  1. Posterior belly of digastric Correct answer.
  2. Stylohyoid ligament
  3. Masseter muscle
  4. Mandibular notch

Explanation

The posterior belly of the digastric and the stylohyoid divide the parotid from the submandibular compartment. This boundary is relevant when planning surgical approaches.

Question 19Head and Neck Anatomy and Tumor Biology

Which finding most strongly suggests malignant transformation of a pleomorphic adenoma?

  1. Slow growth over many years
  2. Painless cystic change on imaging
  3. New rapid growth in a long-standing mass Correct answer.
  4. Bilateral symmetric enlargement

Explanation

Carcinoma ex pleomorphic adenoma typically presents as rapid growth or new pain in a previously stable mass. Malignant transformation is suspected when a long-standing tumor changes behavior.

Question 20Head and Neck Anatomy and Tumor Biology

Which anatomic feature explains the frequent spread of oral cavity tumors to bilateral neck nodes?

  1. Rich midline lymphatic crossover in the floor of mouth and tongue Correct answer.
  2. Dense arterial anastomoses across the midline
  3. Absence of lymphatic vessels in the oral mucosa
  4. Direct venous drainage to the internal jugular vein

Explanation

Midline and near-midline structures such as the floor of mouth and tongue have lymphatic channels that cross to both sides. This crossover produces bilateral or contralateral nodal metastases.

Question 21Head and Neck Anatomy and Tumor Biology

Which molecular event best explains resistance to EGFR inhibitors in head and neck cancer?

  1. Complete absence of EGFR expression
  2. Deletion of the entire EGFR gene
  3. Activation of compensatory bypass signaling such as MET or PI3K Correct answer.
  4. Loss of the blood supply to the tumor

Explanation

Resistance often arises from bypass track activation, including MET amplification or PI3K pathway mutations, which sustain proliferation despite EGFR blockade. Combination strategies target these escape pathways.

Question 22Head and Neck Anatomy and Tumor Biology

A tumor centered in the fossa of Rosenmüller with skull base erosion most likely spreads intracranially via which route?

  1. Foramen ovale
  2. Foramen lacerum and carotid canal Correct answer.
  3. Jugular foramen
  4. Optic canal

Explanation

Nasopharyngeal carcinoma erodes the skull base near the petrous apex and enters the cranium through the foramen lacerum and carotid canal region. This produces cranial neuropathies and cavernous sinus involvement.

Question 23Head and Neck Anatomy and Tumor Biology

Which histologic pattern is characteristic of adenoid cystic carcinoma and predicts its clinical behavior?

  1. Papillary growth with psammoma bodies
  2. Spindle cells with keratin whorls
  3. Clear cells with prominent nucleoli
  4. Cribriform growth with perineural invasion Correct answer.

Explanation

Adenoid cystic carcinoma shows a cribriform (Swiss-cheese) pattern and has a strong tendency for perineural invasion. This explains its late recurrences and distant metastases despite slow growth.

Question 24Head and Neck Anatomy and Tumor Biology

The superior orbital fissure syndrome most typically spares which function?

  1. Extraocular muscle movement
  2. Corneal sensation
  3. Pupillary light reflex
  4. Facial expression Correct answer.

Explanation

The superior orbital fissure transmits CN III, IV, VI, V1, and sympathetic fibers, so eye movement, corneal sensation, and pupillary reflexes are affected. Facial expression is mediated by CN VII, which does not pass through this fissure.

Question 25Head and Neck Cancer Evaluation and Staging

Which structure lies immediately lateral to the thyroid cartilage and is a key landmark for identifying the superior laryngeal nerve during neck surgery?

  1. The hyoid bone
  2. The cricothyroid muscle Correct answer.
  3. The carotid sheath
  4. The sternocleidomastoid muscle

Explanation

The superior laryngeal nerve divides into internal and external branches; the external branch runs along the cricothyroid muscle, making it the key landmark. The carotid sheath and sternocleidomastoid are lateral structures not specific to this nerve.

Question 26Head and Neck Cancer Evaluation and Staging

A patient has a 3 cm oral tongue squamous cell carcinoma with no palpable neck nodes and no distant disease. According to AJCC 8th edition, what is the T category?

  1. T4a
  2. T1
  3. T2 Correct answer.
  4. T3

Explanation

In AJCC 8th edition, oral cavity T2 is defined as tumor greater than 2 cm but not more than 4 cm in greatest dimension. T1 is 2 cm or less, T3 is greater than 4 cm, and T4a involves deep structures such as bone or skin.

Question 27Head and Neck Cancer Evaluation and Staging

In AJCC 8th edition, which feature defines T4a disease for laryngeal squamous cell carcinoma?

  1. Invasion of the strap muscles
  2. Invasion through the outer cortex of the thyroid cartilage Correct answer.
  3. Invasion of the prevertebral space
  4. Vocal cord fixation

Explanation

T4a laryngeal cancer includes invasion through the outer cortex of the thyroid cartilage, invasion of structures beyond the larynx such as the trachea, soft tissues of the neck, strap muscles, or esophagus. Prevertebral space invasion and carotid encasement define T4b.

Question 28Head and Neck Cancer Evaluation and Staging

Which lymph node level corresponds to the submandibular triangle nodes?

  1. Level III
  2. Level IA
  3. Level II
  4. Level IB Correct answer.

Explanation

Level IB contains the submandibular nodes located in the submandibular triangle. Level IA contains submental nodes, Level II upper jugular nodes, and Level III middle jugular nodes.

Question 29Head and Neck Cancer Evaluation and Staging

A patient presents with a nasopharyngeal mass. Which imaging modality is preferred for evaluating the primary tumor and perineural spread?

  1. Ultrasound
  2. Magnetic resonance imaging Correct answer.
  3. Positron emission tomography
  4. Computed tomography

Explanation

MRI provides superior soft tissue contrast and is preferred for nasopharyngeal carcinoma, particularly for detecting skull base invasion and perineural spread. CT is used but is less sensitive for soft tissue and marrow involvement.

Question 30Head and Neck Cancer Evaluation and Staging

Which of the following is the most common site of distant metastasis for head and neck squamous cell carcinoma?

  1. Bone
  2. Lung Correct answer.
  3. Brain
  4. Liver

Explanation

The lung is the most common site of distant metastasis in head and neck squamous cell carcinoma. Bone and liver are less frequent, and brain involvement is uncommon.

Question 31Head and Neck Cancer Evaluation and Staging

A patient with a T2N1M0 oropharyngeal squamous cell carcinoma is being staged. Under AJCC 8th edition, which factor is used to determine the overall stage group for HPV-positive disease?

  1. Tumor grade
  2. Smoking history
  3. p16 status Correct answer.
  4. Nodal size alone

Explanation

AJCC 8th edition uses p16 immunohistochemistry as a surrogate for HPV status to assign a separate staging system for oropharyngeal carcinoma. p16-positive and p16-negative tumors have distinct stage groupings.

Question 32Head and Neck Cancer Evaluation and Staging

Which of the following best describes the approach to a patient with a neck mass and no obvious primary site after physical examination and CT?

  1. Panendoscopy with directed biopsies and PET-CT Correct answer.
  2. Observation for six months
  3. Empiric radiation therapy to the whole neck
  4. Immediate neck dissection without further workup

Explanation

For a cervical metastasis of unknown primary, panendoscopy with directed biopsies (including nasopharynx, base of tongue, and tonsil) plus PET-CT is the standard workup to identify the primary. Blind treatment or observation is inappropriate.

Question 33Head and Neck Cancer Evaluation and Staging

What is the clinical significance of the retropharyngeal lymph nodes in nasopharyngeal carcinoma staging?

  1. They are always benign
  2. They are not staged
  3. They indicate distant metastasis
  4. They are considered regional nodes and affect N category Correct answer.

Explanation

Retropharyngeal lymph nodes are regional nodes in nasopharyngeal carcinoma and their involvement contributes to N category and overall stage. They are not distant disease.

Question 34Head and Neck Cancer Evaluation and Staging

A 5 cm lymph node metastasis in the neck with no extranodal extension in a patient with oral cavity cancer is classified as which N category in AJCC 8th edition?

  1. N1
  2. N2a Correct answer.
  3. N3a
  4. N2b

Explanation

In AJCC 8th edition, N2a is a single ipsilateral node greater than 3 cm but not more than 6 cm without extranodal extension. N1 is a single node 3 cm or less, N2b is multiple ipsilateral nodes, and N3a is greater than 6 cm.

Question 35Head and Neck Cancer Evaluation and Staging

Which of the following is a recognized risk factor for the development of head and neck squamous cell carcinoma?

  1. Tobacco and alcohol use Correct answer.
  2. Chronic tonsillitis
  3. Epstein-Barr virus in the oropharynx
  4. Human papillomavirus in the oral cavity

Explanation

Tobacco and alcohol use are the major established risk factors for head and neck squamous cell carcinoma. HPV is associated mainly with oropharyngeal cancer, and EBV with nasopharyngeal carcinoma.

Question 36Head and Neck Cancer Evaluation and Staging

Which imaging finding is characteristic of perineural spread of head and neck tumors?

  1. Enhancement and thickening of the involved nerve Correct answer.
  2. Nerve atrophy without enhancement
  3. Calcification along the nerve
  4. Fatty replacement of the nerve

Explanation

Perineural spread typically appears as nerve thickening with abnormal enhancement on MRI, often extending along named nerve pathways. Atrophy or fatty replacement is not the characteristic appearance of active tumor spread.

Question 37Head and Neck Cancer Evaluation and Staging

In the AJCC 8th edition, what defines T4b disease in oral cavity carcinoma?

  1. Invasion of the skin of the face
  2. Invasion of the masticator space, pterygoid plates, or skull base, or encasement of the internal carotid artery Correct answer.
  3. Invasion of the mandible
  4. Tumor greater than 4 cm

Explanation

T4b denotes very advanced local disease with invasion of the masticator space, pterygoid plates, or skull base, or encasement of the internal carotid artery. These are unresectable features.

Question 38Head and Neck Cancer Evaluation and Staging

Which of the following is the preferred initial imaging study for a suspected thyroid malignancy with vocal cord paralysis?

  1. Plain radiograph of the neck
  2. Barium swallow
  3. Bone scan
  4. Ultrasound of the thyroid and cervical lymph nodes Correct answer.

Explanation

Ultrasound is the first-line imaging for thyroid nodules and allows assessment of the thyroid gland and cervical lymph node basins. Plain radiographs and barium studies do not evaluate the thyroid or nodes adequately.

Question 39Head and Neck Cancer Evaluation and Staging

A patient has a parotid mass with facial nerve weakness. What does facial nerve involvement most likely indicate?

  1. Sialolithiasis
  2. A simple cyst
  3. Malignant infiltration of the nerve Correct answer.
  4. A benign pleomorphic adenoma

Explanation

Facial nerve weakness in a patient with a parotid mass is a red flag for malignancy with perineural invasion. Benign lesions such as pleomorphic adenoma or cysts do not typically cause facial nerve palsy.

Question 40Head and Neck Cancer Evaluation and Staging

Which of the following best describes the role of sentinel lymph node biopsy in head and neck cancer?

  1. It is used only for nasopharyngeal carcinoma
  2. It may be used to stage the clinically node-negative neck in early oral cavity cancer Correct answer.
  3. It is standard for all T1 oral cavity tumors
  4. It replaces neck dissection for all N2 disease

Explanation

Sentinel lymph node biopsy is an accepted option for staging the clinically node-negative neck in early oral cavity squamous cell carcinoma, helping select patients for neck dissection. It does not replace dissection for bulky nodal disease.

Question 41Head and Neck Cancer Evaluation and Staging

Which of the following is a feature of T3 glottic carcinoma?

  1. Tumor limited to one vocal cord
  2. Vocal cord fixation Correct answer.
  3. Invasion of the prevertebral space
  4. Invasion through the outer thyroid cartilage cortex

Explanation

T3 glottic carcinoma includes vocal cord fixation and invasion of the paraglottic space or inner cortex of the thyroid cartilage. Prevertebral invasion and outer cartilage cortex invasion are T4 features.

Question 42Head and Neck Cancer Evaluation and Staging

Which of the following statements about the N category in AJCC 8th edition for head and neck cancers (non-HPV, non-nasopharynx) is correct?

  1. N3b indicates a single node greater than 6 cm without extranodal extension
  2. N1 indicates a single ipsilateral node 3 cm or less without extranodal extension Correct answer.
  3. N2a indicates bilateral nodes
  4. N0 indicates nodes present but not palpable

Explanation

N1 is a single ipsilateral node 3 cm or less without extranodal extension. N2a is a single ipsilateral node greater than 3 cm but not more than 6 cm, N3b is any node with clinically overt extranodal extension, and N0 means no regional node metastasis.

Question 43Head and Neck Cancer Evaluation and Staging

A patient with sinonasal cancer has tumor invading the orbit. Which structure involvement most strongly influences the T category?

  1. Orbital contents Correct answer.
  2. Nasal septum
  3. Ethmoid air cells
  4. Maxillary sinus mucosa

Explanation

Invasion of orbital contents is a high T category feature in sinonasal malignancy, reflecting advanced local disease. Involvement of the septum or mucosa alone is less advanced.

Question 44Head and Neck Cancer Evaluation and Staging

Which of the following is the most appropriate next step for a patient with a newly diagnosed head and neck cancer and a solitary pulmonary nodule on staging CT?

  1. Obtain tissue diagnosis of the nodule to exclude metastasis Correct answer.
  2. Start chemotherapy without further evaluation
  3. Repeat CT in one year
  4. Assume it is benign and proceed with treatment

Explanation

A solitary pulmonary nodule in a patient with head and neck cancer may represent metastasis or a second primary, so tissue diagnosis is needed to guide treatment. Assuming benignity or delaying evaluation risks inappropriate therapy.

Question 45Head and Neck Cancer Evaluation and Staging

Which of the following best describes the role of the p16 marker in oropharyngeal cancer?

  1. It confirms the presence of HPV DNA directly
  2. It predicts response to radiation only
  3. It is used to stage nasopharyngeal cancer
  4. It serves as a surrogate marker for transcriptionally active HPV Correct answer.

Explanation

p16 overexpression is used as a surrogate marker for transcriptionally active high-risk HPV in oropharyngeal carcinoma and drives the separate AJCC staging system. It is not a direct HPV DNA test.

Question 46Head and Neck Cancer Evaluation and Staging

Which of the following is a characteristic of the T1 category for glottic carcinoma?

  1. Tumor with prevertebral invasion
  2. Tumor invading the thyroid cartilage
  3. Tumor limited to one or both vocal cords with normal mobility Correct answer.
  4. Tumor with vocal cord fixation

Explanation

T1 glottic carcinoma is limited to the vocal cords with normal mobility. Fixation is T3, cartilage invasion is T4a, and prevertebral invasion is T4b.

Question 47Head and Neck Cancer Evaluation and Staging

Which of the following is the most common histology of salivary gland malignancies in the parotid gland?

  1. Acinic cell carcinoma
  2. Mucoepidermoid carcinoma Correct answer.
  3. Adenoid cystic carcinoma
  4. Squamous cell carcinoma

Explanation

Mucoepidermoid carcinoma is the most common primary salivary gland malignancy, particularly in the parotid. Adenoid cystic and acinic cell carcinomas are less common.

Question 48Head and Neck Cancer Evaluation and Staging

Which of the following best describes the recommended evaluation of a patient with a suspected head and neck cancer and a clinically positive neck?

  1. Observation for three months
  2. Fine-needle aspiration of the neck node for tissue diagnosis Correct answer.
  3. Immediate radical neck dissection without diagnosis
  4. Empiric antibiotics

Explanation

Fine-needle aspiration of a suspicious neck node provides tissue diagnosis and helps identify the tumor type before definitive treatment. Observation or empiric antibiotics delay diagnosis.

Question 49Head and Neck Cancer Evaluation and Staging

Which feature distinguishes T4a from T4b in hypopharyngeal carcinoma?

  1. Invasion of the prevertebral fascia or carotid encasement Correct answer.
  2. Invasion of the thyroid cartilage
  3. Vocal cord fixation
  4. Tumor size greater than 4 cm

Explanation

T4b hypopharyngeal carcinoma involves the prevertebral fascia, encases the carotid artery, or invades mediastinal structures. T4a involves invasion of the thyroid or cricoid cartilage, hyoid bone, thyroid gland, or esophageal muscle.

Question 50Head and Neck Cancer Evaluation and Staging

A 58-year-old man presents with a 2 cm ulcerated lesion on the lateral border of the tongue. There is no palpable cervical lymphadenopathy and no evidence of distant metastasis. According to the AJCC 8th edition, what is the clinical T classification?

  1. T3
  2. T4a
  3. T2 Correct answer.
  4. T1

Explanation

In the AJCC 8th edition, T2 oral cavity carcinoma is defined as a tumor larger than 2 cm but not larger than 4 cm in greatest dimension. A 2 cm lesion falls into this category. T1 is defined as tumor 2 cm or less, T3 as greater than 4 cm, and T4a as moderately advanced local disease with invasion of adjacent structures.