An official website of the United States government
Home
SEER Inquiry System - Report
Produced: 04/04/2026 3:21 AM
Question 20091120
Inquiry Details
References:
2007 SEER Manual, C-1065. Appendix C
Question:
MP/H Rules/Histology--Esophagus: Should the modifying expression "with areas of" be used to code histology? See Discussion.
Discussion:
Patient was found to have two tumors in the esophagus. The large tumor was diagnosed as adenocarcinoma with areas of neuroendocrine differentiation (small cell carcinoma). The smaller tumor was diagnosed as small cell carcinoma. If we accept the "areas of" to be part of the diagnosis, rule H16 indicates that histology for the large tumor would be coded 8045 (combined small cell and adenocarcinoma). If we ignore the "areas of," then histology for the large tumor would be coded to 8140 (adenocarcinoma). Either way, when counting primaries, rule M17 would be applied and the two tumors would be classified as separate primaries. However, it seems that the two tumors are probably the same disease process since they both show small cell carcinoma.
Answer:
For cases diagnosed 2007 or later, do not use the modifying expression "with areas of" to determine a more specific histology per rule H13 in the MP/H rules.
