Solid Tumor Rules (2018)/Histology--Corpus uteri: What is the correct histology code for "Mesophrenic-like adenocarcinoma" of the corpus uteri?" See Discussion.
The article I read (https://www.ncbi.nlm.nih.gov/pubmed/?term=28984674) makes the distinction between mesophrenic adenocarcinoma and mesophrenic-like adenocarcinoma. The authors propose the term mesonephric-like Mullerian adenocarcinoma. So would this be coded as Mullerian adenocarcinoma?
Assign code 9110/3, mesonephric adenocarcinoma. These tumors commonly arise in the cervical wall and more commonly involve the lower uterine segment than do other cervical adenocarcinomas.
Marital Status: Is Marital Status always a self-reported status? See Discussion.
The SEER Manual states that Marriage is self-reported for the instruction in code 2, but it does not indicate if all other marital statuses are self-reported.
Examples: How is Marital Status reported for the following situations?
1. Patient with multiple tumors in the database, for the first tumor marital status is reported as married (code 2), for the subsequent tumor, marital status is reported as single (code 1).
2. Patient self- reports as single, but also has children.
3. Patient states they are in common law marriage, but our state is not a common law marriage state.
Marital Status is self-reported because the information is recorded in the medical record based on information obtained from the patient. Use text fields to document relevant information.
Examples
1. Assign code 2 for the first tumor and assign code 1 for the subsequent tumor unless the available information indicates the patient is divorced at the time of the subsequent tumor diagnosis. Patient may self-report single after a divorce. Assign code 4 in that situation.
The code assigned for marital status reflects the patient's marital status at the time of diagnosis for the tumor being abstracted. It is possible that marital status may be different for each tumor if the patient has multiple tumors.
2. If marital status is stated to be single, assign code 1.
3. If marital status is stated to be common law marriage, assign code 2.
Common Law Marriage is defined as a couple living together for a period of time and declaring themselves as married to friends, family, and the community, having never gone through a formal ceremony or obtained a marriage license.
MP/H Rules/Histology--Brain and CNS: How should histology be coded for the following 2017 cases (pituitary adenoma vs. prolactinoma)? See Discussion.
1. (2017) Pituitary mass resection with a path diagnosis of
Do we code as prolactinoma when the tumor is immunoreactive for prolactin or must there be a definitive statement of ?
2. (2017) Pituitary lesion on imaging, MD diagnosis of
Current (2007) MP/H rule H9 states when there are multiple histologies in the same branch in Chart 1, code the more specific histology. These histologies are NOT in Chart 1, but prolactinoma seems to be a more specific type of pituitary adenoma. The next rule, H10 states to code the numerically higher code, 8272/0 (pituitary adenoma)?
3. (2017) Imaging diagnosis of pituitary macroadenoma with clinical diagnosis by MD of macroprolactinoma.
Current rules indicate when there is no path specimen that physician reference to type of tumor has priority over imaging.
Will these answers/histologies change with the upcoming 2018 Solid Tumor rules?
Code each of these 2017 cases as prolactinoma (8271/0), the more specific histology.
If these cases were diagnosed in 2018, the answer would be the same: code as prolactinoma.
Histology--Ovary: What is the correct ICD-O-3 histology code for sertoliform endometrioid carcinoma of the ovary?
Assign 8380/3. Sertoliform endometrioid carcinoma is a variant of endometrioid carcinoma according to the WHO Classification of Tumors of Female Reproductive Organs, 4th edition. There is no specific ICD-O-3 code for this variant.
Reportability/Histology--Brain and CNS: Is multinodular and vacuolating neuronal tumor of the cerebrum reportable, and if so, is the histology coded as 9492/0? See Discussion.
Patient diagnosed with multinodular and vacuolating neuronal tumor of the cerebrum. My research shows: Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. There is no code in ICD-O-3 for it, so do I report it and use 9492/0 or not ?
Do not report multinodular and vacuolating neuronal tumor of the cerebrum. At this time, WHO is undecided about whether this is a neoplastic or a hamartomatous/malformative process. If WHO makes a determination that this is a neoplastic process, we will update reportability instructions and ICD-O-3 guidelines for registrars.
Reportability--Brain and CNS: Are tuberous sclerosis cancers found in the brain reportable? See Discussion.
I have searched ICD-O-3 for a histology listing but could not locate. I also searched the SEER Inquiry database for possible answers, but none were found. The patient underwent a pediatric MRI of the brain of which final impression was: 1) Subependymoma nodules, cortical tubers, and SEGAs are seen bilaterally consistent with tuberous sclerosis.
SEGA (Subependymal giant cell astrocytoma) is reportable if diagnosed in 2004 or later. Tuberous sclerosis complex (TSC) is not a neoplasm and is not reportable. SEGA is a neoplasm that commonly occurs in TSC patients.
First course of treatment: What is the correct code to use for allogenic stem cell transplant?
Code an allogenic stem cell transplant as 20 (Stem cell harvest (stem cell transplant) and infusion) in Hematologic Transplant and Endocrine Procedures in the 2016 SEER Manual.
Diagnostic confirmation--Heme & Lymphoid Neoplasms: Is Diagnostic Confirmation coded as 5 (positive laboratory test/ marker study) or code 8 (clinical diagnosis only) for a case that has a positive JAK2 mutation, and based on the results of the JAK2, the physician diagnosed the patient with polycythemia vera? There were no blood smears or bone marrow biopsies done.
Assign diagnostic confirmation code 5 for a positive laboratory test/marker study. A note was added to the Hematopoietic manual to state that code 5 now includes cases with no histological confirmation but there is positive immunophenotyping or genetic studies.
Reportability--Head & Neck: Is dentinoameloblastoma reportable, and if so, what is the correct histology code? See Discussion.
Mixed odontogenic tumor consistent with dentinoameloblastoma, 9.5 cm, See Note: Tumor involves maxillary bone including hard palate, alveolar ridges, nasal cavities and maxillary sinuses bilaterally and buccal soft tissue. Lymphovascular invasion not identified. Perineural invasion not identified. Margins: Tumor involves right posterior bone (alveolar) margin. All other margins negative. Note: This is a rare hybrid tumor showing features of ameloblastoma producing pre-dentin/osteodentin matrix. Submucosal tumor is seen in the nasal cavities and palate. A congo red stain shows that the acellular dentin-like matrix fluoresces similar to collagen after polarization. Immunohistochemistry shows that the tumor cells are diffusely and strongly positive for p63, focally positive for CK19, and negative for CK5/6, SOX10, S100 and calretinin.
Dentinoameloblastoma is not reportable. It is a variant of ameloblastoma which produces dentin and/or osteoid. It is benign. It can extend locally in a rather aggressive fashion, but is not given a malignant designation unless it metastasizes.
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