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SEER Inquiry System - Report
Produced: 11/26/2024 9:30 AM
Question 20210063
Inquiry Details
References:
Solid Tumor Rules. Other Sites, September 2021 Update
Question:
Solid Tumor Rules (2018/2021)/Multiple primaries--Ovary: How many primaries should be reported and for which primary site(s) when pathologist identifies bilateral ovarian high-grade serous carcinoma with involvement of the left fallopian tube (also showing serous tubal intraepithelial carcinoma (STIC))? See Discussion.
Discussion:
Patient is diagnosed July 2021 with high-grade serous carcinoma on ascites cytology. Tumor debulking total abdominal hysterectomy/bilateral salpingo-oophorectomy in August shows high-grade serous carcinoma involving the right ovary (capsule intact, right fallopian tube is negative), left ovary (capsule ruptured), and fallopian tube. Pathologist has chosen tumor site to be bilateral ovaries in the staging summary, with the left fallopian tube listed as “other tissue/organ involvement” along with uterus, peritoneum, and omentum. Additional findings in staging summary includes serous tubal intraepithelial carcinoma (STIC).
Our interpretation of SINQ 20210025 is that any case with both ovarian and tubal involvement would be coded as a fallopian tube primary if STIC is present, even when the pathologist is clearly calling the case ovarian. If this is correct, then the previous SINQ 20120093 may need to be updated with a date restriction reference since it would be in disagreement with this instruction.
If our interpretation is incorrect, then the STIC would be an additional primary per MP/H Rule M11.
Answer:
Bilateral ovarian tumors are a single primary per M7. Abstract the STIC as a second primary.
SINQ 20210025 is intented to address situations with confliciting information about the primary site. The answers remain unchanged in 2012009 and 20210025.
