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SEER Inquiry System - Report
Produced: 03/15/2026 2:43 AM
Question 20130024
Inquiry Details
References:
2007 MP/H Rules
Question:
MP/H Rules/Histology--Bladder: How many primaries are accessioned and what rule applies when the patient has a mixed tumor with a urothelial carcinoma, NOS and a more specific histologic type followed by a diagnosis of urothelial carcinoma? See Discussion.
Discussion:
The MP/H Rules do not specifically cover how to process urothelial carcinomas with a more specific type of carcinoma.
Patient 1: Diagnosed in April 2010 with invasive urothelial carcinoma with signet ring features of the bladder. Site and histology are coded as C679 [bladder] and 8490/3 [signet ring cell carcinoma]. In January 2012 a subsequent diagnosis of invasive urothelial carcinoma of the bladder is made [C679, 8120/3].
Patient 2: Diagnosed in November 2009 with invasive papillary urothelial carcinoma with micropapillary and mucinous features of the bladder. Site and histology are coded C679 [bladder] and 8480/3 [mucinous carcinoma]. In April 2012 a subsequent diagnosis of high grade papillary and flat urothelial carcinoma without evidence of invasion is made [C679, 8130/2].
Does rule M9 apply and these are new primaries?
Answer:
For cases diagnosed 2007 and later, accession two primaries for each patient, signet ring cell carcinoma of the bladder and invasive urothelial carcinoma of the bladder for patient 1 and mucinous carcinoma of the bladder and non-invasive papillary urothelial carcinoma of the bladder for patient 2.
The steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Urinary MP rules because site specific rules exist for this primary.
Start at the MULTIPLE TUMORS module, rule M3. The rules are intended to be reviewed in consecutive order within a module. For both patients, rule M9 applies because the tumors have histology codes that are different at the second (xxx) number.
This guideline will be reviewed for the next version of the MP/H Rules.
