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Assign 8323/3, clear cell papillary renal cell carcinoma using the 2018 Kidney Solid Tumor Rules, Rule H1, as this is a single histology, a variant of renal cell carcinoma NOS.

When the choice is between ovary, fallopian tube, or primary peritoneal, any indication of fallopian tube involvement indicates the primary tumor is a tubal primary. Fallopian tube primary carcinomas can be confirmed by reviewing the fallopian tube sections as described on the pathology report to document the presence of either serous tubal intraepithelial carcinoma (STIC) and/or tubal mucosal invasive serous carcinoma.

If there is no information about the fallopian tubes, refer to the histology and look at the treatment plans for the patient. If all else fails, you may have to assign C579 as a last resort. Use text fields to document the details.

For additional information, see the CAP GYN protocol, Table 1: Criteria for assignment of primary site in tubo-ovarian serous carcinomas.

For this case, report each GIST diagnosis separately. This differs from SINQ 20190041 because in that case the stomach GIST was incidental and measured only 0.3 cm. Reporting these separately means that each one is no longer a multifocal tumor. If there is no other indication of malignancy for these, they would not be reportable if diagnosed in 2020 or earlier.

For cases diagnosed 2021 or later, all GIST are reportable. Report this as two primaries. Use the new GIST schema for EOD and assign EOD Primary Tumor 100 for each. There is no mention of extension outside the primary site. Summary Stage is Localized for each.

Review this case with the involved physicians to determine their opinion on the bone mass. Review the plans for further evaluation and treatment (if any) to determine whether the physicians view this case as a chondroid lesion, chondrosarcoma, or something else.

If it is not possible to obtain further information, do not report the case at this time. If further information becomes available, review the case again for reportability.

In situ encapsulated papillary arising in or with invasive carcinoma, NST (a single tumor) is a single invasive histology. Use rule H14 and code the histology per Table 3.

A note as been added to the 2023 breast rule H8 instructing when there is a single tumor with histology of in situ encapsulated papillary with invasive carcinoma or solid papillary carcinoma with invasove, continue through the rules. See H14 and code the appropriate histology per Table 3.

Histologic types are becoming more complex and often have both in situ and invasive components but have a single code to identify them.

The original issue with M10 was with registrars being instructed that multiple in situ and invasive tumors were a single primary and then coding 8522/3 when one tumor was in situ and one was invasive. This incorrectly identified both components as being malignant (/3). Our effort to correct this misconception apparently did not work. M10 has been revised to state that yes, an in situ lobular or duct plus an invasive lobular or duct is a single primary with a new note that states: When a mixture of behaviors is present in carcinoma, NST, and lobular carcinoma, follow the H rules to determine the correct histology code. They will stop at H8 which instructs them to code the invasive histology. 8522/3 should only be used when both components are invasive.

Code as Localized using the SEER Summary Stage Manual, Colon and Rectum, Note 6.

Localized is for subsites that are not peritonealized, including the posterior side of the ascending colon, or when the pathologist does not further describe the "pericolic/perirectal tissues" as either "non-peritonealized pericolic/perirectal tissues" vs "peritonealized pericolic/perirectal tissues" fat and the gross description does not describe the tumor relation to the serosa/peritoneal surface, and it cannot be determined whether the tumor arises in a peritonealized portion of the colon.

Refer to the coding instructions in both EOD and Summary Stage for a list of sites that are nonperitonealized or peritonealized.

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Cutaneous leiomyosarcoma is reportable for 2019. Code histology to leiomyosarcoma 8890/3.

As of cases diagnosed 1/1/2021, it is no longer reportable based on assignment to 8897/1 in ICD-O-3.2.

Abstract multiple primaries using 2018 Head and Neck Solid Tumor Rule M8 as these are separate tumors described as arising close together, and are on different rows in Table 3. Code histology separately as squamous cell carcinoma (8070/3) and mucoepidermoid carcinoma (8430/3).

This appears to be a collision tumor. Collision tumors are counted as two individual tumors for the purpose of determining multiple primaries. Collision tumors were originally two separate tumors that arose in close proximity. As the tumors increased in size, they merged or overlapped each other. While more common in the colon, they can occur in other sites as well.

Report retinal astrocytoma. The WHO Classification of Tumors of the Eye, 4th edition, lists astrocytoma, NOS as 9400/3 with astrocytic hamartoma of the retina as a synonym. You may receive a site/type edit (IF25) which can be overridden.

The changes in terminology, codes, etc. proposed in WHO 4th Ed Eye book were implemented for cases diagnosed 1/1/2018 forward. Apply this to retina astrocytomas and do not accession cases diagnosed with this histology prior to 1/1/2018.