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Report Produced: 04/25/2026 19:40 PM

Report Question ID Question Discussion Answer Year
20071006 Primary Site: Is an "angiosarcoma" stated as arising in the skin of the breast and treated with a mastectomy, coded to the primary site of skin or breast?

Code the primary site as skin of breast when skin of breast is documented as the site of origin.

According to the WHO classification of soft tissue tumors, the majority of angiosarcomas "develop as cutaneous tumors...less than one quarter present as a deep soft tissue mass."

 2007
20071011 Multiple Primaries (Pre-2007)--Breast: How many primaries are to be abstracted when each of multiple breast "re-excisions" performed more than two months apart in 2006 demonstrate intraductal carcinoma and there is no mention of "recurrence"? See Discussion.

Right Breast

06/27/2002 exc bx, DCIS. Margins involved.

09/24/2002 re-exc, several foci of intraductal ca. Margins involved.

10/15/2002 re-exc, microfocus of DCIS

Radiation treatment started 11/18/2002.

Is this 1, possibly 2, or maybe 3 breast primaries because of the 2 month rule and no statement of "recurrence"? Based on SINQ #20000478, this would be at least 2, but possible 3 primaries. Based on SINQ #20021143, this would be 1 primary if the case were diagnosed from 1998-2003. The excisions appear to represent wider excisions of the same tumor.

For cases diagnosed prior to 2013:

For tumors diagnosed prior to 2007, this is one primary, assuming these are wider excisions of the same tumor.

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

 2007
20071092 Reportability/Primary Site--Brain and CNS: Is a chondroma, NOS or a chondroblastoma, NOS that occurs in an intracranial site or along the spinal cord reportable? See Discussion.

In ICD-O-3, chondroma and chondroblastoma are site-associated morphologies for bone. If a chondroma or a chondroblastoma occurs along the spinal cord, is this one of those situations where we can be quite comfortable with a default site to bone and not to spinal cord?

Reference: ICD-O-3; Primary Central Nervous System Tumors, NPCR Training Materials 2004; SINQ 20021152

Chondroma, NOS or chondroblastoma, NOS occuring in intracranial sites or along the spinal cord are not reportable.

Chondroma, NOS and chonroblastoma, NOS are benign tumors of the bone itself, not the intracranial contents.

 2007
20071088 Type of Multiple Tumors--Lung: Is this field coded to 40 [Multiple invasive] or 80 [Unk in situ or invasive] when only one nodule is biopsied of multiple existing nodules for a reported single lung primary? See Discussion.

The right lung has 4 tumor nodules in the upper lobe. Biopsy of one tumor is positive for moderately differentiated adenocarcinoma. No other work up performed.

Should code 40 be used because we dont know the behavior of the other nodules?

 The best code to use in this case is 40 [multiple invasive]. For lung only, it is assumed that all of the tumors are the same histology and that all are invasive. 2007
20071044

Date of Conclusive Terminology: Is there an applicable timeframe when coding this field?

There is no strict timeframe for Date of Conclusive Terminology. The diagnosis using conclusive terminology could be made any time following the diagnostic work-up.

The date of conclusive terminology is related to code 2 [ambiguous term followed by conclusive term] in the data item "Ambiguous terminology." Assign code 2 when a conclusive diagnosis is made 60 days or more after a diagnosis using ambiguous terminology. Record the date of the conclusive diagnosis in "Date of Conclusive Terminology."

 2007
20071098 Multiplicity Counter/Date of Multiple Tumors/CS Tumor Size--Lung: How are these fields to be coded when work-up of a malignancy spans a couple of months and reveals developing nodules? See Discussion. Example: Chest CT on 4-26-07 reveals 2.2 cm mass in lingula, left lung, consistent with lung malignancy. Biopsy on 5-18-07 shows non-small cell carcinoma. PET scan on 6-6-07 shows left upper lobe mass consistent with known non-small cell lung carcinoma. Second developing mass increasing in prominence since 4-07 in periphery of left upper lobe, approximately 3.6 cm which may represent intrapulmonary mets or second primary neoplasm. At least 3 additional intrapulmonary nodules have developed since 4-07, two in the left upper lobe and one in the right upper lobe, suspicious for mets.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Multiplicity Counter/Date of Multiple Tumors

Apply the multiple primary rules first and record the number of tumors determined to be a single primary in Multiplicity Counter. Record the corresponding date in Date of Multiple Tumors. These data items may be updated once if future tumors are determined to be the same primary as the initial diagnosis.

CS Tumor Size

Include information gathered through

  • completion of surgery(ies) in first course of treatment OR

  • all information available within four months of the date of diagnosis in the absence of disease progression

    • WHICHEVER IS LONGER.

    Metastasis known to have developed after the diagnosis was established should be excluded.

    		 2007
    		20071036 MP/H Rules/Histology--Thyroid: Is a "papillary carcinoma of the thyroid" coded to 8260/3 [Papillary adenocarcinoma] per the ICD-O-3 because it lists "papillary carcinoma of the thyroid" as a synonym for that code or should it be coded to 8050 [Papillary carcinoma, NOS]? For cases diagnosed 2007 or later, assign code 8260 [papilary carcinoma of the thyroid]. 2007
    		20071029 CS Lymph Nodes--Kidney, renal pelvis: Under what circumstances would code 80 [Lymph nodes, NOS] be used to document the presence of positive lymph nodes? See Discussion. The CS Schema for Kidney (Renal Parenchyma) states to use code 70 for Regional Lymph Nodes, NOS. The schema for for Renal Pelvis states to use code 50 for Regional Lymph Nodes, NOS. Both schemas have a Code 80, for Lymph Nodes, NOS that maps to N1 in both schemas.

    This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Code 80 can be used for positive lymph nodes when you are unable to determine if they are regional or distant. CS Lymph Nodes code 80 is provided for this situation in accordance with the downstaging rule.

    Code 80 should be used very infrequently and only when there is no indication whether the involved lymph nodes are regional or distant.

    		 2007
    		20071117 MP/H Rules/Histology--Brain: How many primaries are reported and what is the histology for a single brain tumor described as a low grade astrocytoma at the time of the initial partial resection and a low grade glioneuronal neoplasm at the time of the subsequent total resection? See Discussion. On 4/20/07 a partial resection of a brain tumor is interpreted as low grade astrocytoma. Patient has a gross total resection on 8/13/07 with this diagnosis: low grade glioneuronal neoplasm (see comment). Comment: This case has been reviewed at ---. Dr. agrees with our interpretation (low grade glioneuronal neoplasm, possibly a dysembryoplastic neuroepithelial tumor).

    For cases diagnosed 2007 or later, this is a single primary. A single tumor is always a single primary.

    Assign histology code 9400/3 [Astrocytoma, low grade]. This diagnosis was not revised or amended based on the later surgery. It is possible that the malignant component was entirely removed during the first surgery.

    		 2007
    		20071106

    MP/H Rules--Bladder: Does rule M6 mean that any combination of tumors with the histologies 8050, 8120-8124, or 8130-8131 are the same primary regardless of the amount of time between tumor occurrences? See Discussion.

    Many interpret Rule M7 to mean when separate occurrences of TCC of the bladder are diagnosed more than 3 years apart, it is reportable as a second primary. However, doesn't Rule M6 mean that if the histology is any combination of 8050, 8120-8124 or 8130-8131 for tumors diagnosed more than 3 years apart, they are reported as a single primary?

    For cases diagnosed 2007 or later:

    Papillary, transitional cell and/or papillary transitional cell carcinomas of the bladder are a single primary using Rule M6. Rule M6 includes diagnoses within 3 years of each other AND diagnoses more than three years apart for the histologies listed. If rule M6 applies to your case, stop. Do not continue on to Rule M7.

    		 2007