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SEER Inquiry System - Report
Produced: 11/28/2024 3:48 AM
Question 20071111
Inquiry Details
References:
2007 SEER Manual, C-495 to C-496. Appendix C
Question:
Discussion:
A RUL lung wedge resection and RML and RLL lobectomies were performed. The RUL resection showed invasive adenocarcinoma with bronchioalveolar-like features. Tumor size 9x.9x.8cm. The RLL lobectomy showed invasive non-small cell carcinoma with clear cell features. Tumor size 4.1x2.5x1.8cm. The RML lobectomy showed invasive adenocarcinoma. Tumor size 3.0x1.6x2.2cm.
Comment: Essentially three invasive tumors and a focus of bronchioalveolar carcinoma were identified in 3 specimens. All of the tumors appear somewhat histologically different. The larger tumors in the right upper and middle lobe were somewhat similar but still appear histologically different and therefore the pathologic staging is done based on all tumors being separate. The pathologic staging for this case is pT2(4) pN0 pMX.
What histology code and what site code are to be used on each abstract?
Answer:
For cases diagnosed 2007 or later:
Abstract two primaries:
- C349 with histology coded to 8140 - invasive adenocarcinoma (RUL and RML)
First, determine the number of tumors. There are three separate tumors in right lung in the example above:
- RUL: invasive adenocarcinoma, bronchioalveolar-like features (8140, "-like" is not on the list of ambiguous terms used to code histology)
Because there are three tumors, begin with rule M3 in the Multiple Tumors module. Stop at rule M11, multiple primaries for the tumor in the RLL (8310) compared to the tumors in the RUL and RML (8140 and 8140).
Now evaluate the tumors in the RUL and RML using the multiple primary rules. Start at rule M3 and stop at rule M12, single primary.
