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SEER Inquiry System - Report
Produced: 10/14/2025 8:28 PM
Question 20240029
Inquiry Details
References:
Solid Tumor Rules. Head and Neck, 2024 Update
Question:
Solid Tumor Rules/Multiple Primaries--Head and Neck: Is a 11/2023 diagnosis of invasive squamous cell carcinoma (SCC) in lower gum (C031) a new primary and what rules apply for a patient with 09/2017 invasive SCC of lower gum (C031) and 05/2022 invasive SCC of lateral tongue (C023)? See Discussion.
Discussion:
The 11/2023 lower gum tumor is a separate tumor occurring after a disease-free interval, so we know the Head and Neck Multiple Tumors Module applies. However, our staff is having difficulty applying the rules to this particular scenario with consistent results.
Is the 11/2023 SCC a non-reportable recurrence per M12, since M4 is ignored due to patient’s prior 2017 C031 (lower gum) primary, and then M6 is ignored due to patient’s prior 05/2022 C023 primary?
Or is the 11/2023 SCC a new primary per M4, since the last diagnosis was in a site differing at the third character (C03 vs C02)? If M4 does not apply due to patient's previous C03 primary, then does M6 apply since it has been more than 5 years since the previous C03 primary?
Answer:
Abstract three primaries for the scenario you describe.
- 09/2017 invasive SCC of lower gum (C031)
- 05/2022 invasive SCC of lateral tongue (C023): Apply Rule M4, differ at 3rd site code
- 11/2023 SCC of lower gum (C031): Apply Rule M6, greater than 5 years from the 9/2017 C031
