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Report Produced: 09/21/2025 03:43 AM

Report Question ID Question Discussion Answer Year
20091009 MP/H Rules/Histology--Kidney: How do you code histology for a renal cell carcinoma when pathologists disagree as to whether or not the tumor is consistent with thyroid-like follicular carcinoma of the kidney? See Discussion. Final diagnosis states 'left radical nephrectomy, renal cell carcinoma.' The CAP Histologic Type is listed as: Unclassified, most consistent with primary thyroid-like follicular carcinoma of the kidney.' Because of the unusual histology it was sent for a consult to a genitourinary pathology specialist. His response was: 'histologic features not typical for any of the known subtypes of renal cell carcinoma and are not consistent with primary thyroid-like follicular carcinoma of the kidney, a distinct renal tumor that we have recently published in the literature.' The tumor was TTF-1 negative, arguing against metastasis from a thyroid primary. For cases diagnosed 2007 or later, assign code 8312 [renal cell carcinoma, NOS]. The diagnosis is renal cell carcinoma, but the specific type is in question. 2009
20091100

MP/H Rules/Histology--Melanoma: How is histology coded for a "melanoma in situ, lentiginous type," arising in the skin of the lower leg? See Discussion.

In researching this, acral lentiginous melanoma is observed on the palms, soles and under the nails. To code to 8744, do we specifically have to see the word "acral" lentiginous melanoma?

For cases diagnosed 2007 to 2020

Assign 8742/2 [lentigo maligna] to "melanoma in situ, lentiginous type."

Acral lentiginous melanoma is not the same as melanoma, lentiginous type. "Acral lentiginous melanoma," 8744, should be used only if the report states acral lentiginous melanoma or malignant melanoma, acral lentiginous type.

Acral lentiginous melanoma most often occurs on the soles of the feet or the palms of the hands.

 2009
20091016 CS Extension--Pancreas: How do you code this field for a head of pancreas primary with involvement of portal and splenic veins? See Discussion. The splenic artery/vein is only mentioned in the body and tail scheme; no mention is made of this site in the pancreatic head scheme.

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.Assign CS extension code 54 [major blood vessels]. The portal vein is listed under code 54 for head of pancreas. The splenic vein branches from the portal vein.

 2009
20091019 MP/H Rules/Histology--Hematopoietic, NOS: Can a diagnosis of multiple myeloma be made if a bone marrow biopsy is negative? See Discussion. Patient with large mass nasal cavity. Biopsy shows plasmacytoma. Fine needle aspiration of the acetabulum is consistent with multiple myeloma. Skeletal survey shows multiple lytic lesions. Bone marrow biopsy is negative for myeloma. In light of negative bone marrow biopsy can this case be coded as multiple myeloma?

For cases diagnosed prior to 1/1/2010:Code this case as multiple myeloma. The fine needle aspiration of the acetabulum is a biopsy of bone marrow. According to our pathologist consultant, the positive bone marrow biopsy (acetabulum) and the multiple lytic bone lesions confirm multiple myeloma. The negative bone marrow biopsy is likely due to an insufficient sample.

For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

 2009
20091013

Reportability--Skin: Is a "basal cell carcinoma of the skin of the lip with focal skin appendage differentiation" reportable?

The histology code for basal cell carcinoma with skin appendage differentiation is 8098/3. Basal cell carcinomas (8090-8110) are not reportable to SEER. Skin appendage tumors are not reportable to SEER unless stated to be carcinoma or stated to be malignant.

According to our pathologist consultant, basal cell carcinoma with focal skin appendage differentiation is basal cell carcinoma which exhibits adnexal (appendage) features, but it is still basal cell carcinoma.

The case example above is not reportable to SEER.

 2009
20091131 Multiplicity Counter/Type of Multiple Tumors--Breast: How are these fields coded when a patient underwent a lumpectomy demonstrating two measured foci of invasive ductal carcinoma (1.5 cm and 3 mm) and "focally seen" in situ ductal carcinoma (DCIS) followed by a re-excision that is positive for 1.5 mm focus of residual invasive carcinoma? See Discussion.

Lumpectomy path shows two foci of invasive ductal carcinoma, 1.5 cm & 3 mm sizes, and CAP summary lists "DCIS: focally seen", no further description. The re-excision pathology specimen finds a 1.5 mm focus of residual invasive carcinoma, very close to the new inferior margin (so registrar assumed this was probably not part of the previously excised mass), and no mention of any more in situ.

Can we assume the DCIS was associated with/part of the invasive tumors because it was not measured or described separately? If we say there are 3 tumors (for the measured invasive foci), should Type of Multiple Tumors be coded 30 [In situ and invasive] or 40 [Multiple invasive]?

Code 03 [3 tumors] in the multiplicity counter. Do not count the "focally seen" DCIS because it was not measured.

Code 30 [In situ and invasive] in Type of Multiple Tumors Reported as One Primary. The single primary reported for this case is a combination of in situ and invasive tumors.

2009
20091026 CS Extension--Extramedullary Plasmacytoma: Under what circumstance would CS extension code 80 be used in a case of extramedullary plasmacytoma?

For cases diagnosed prior to 1/1/2010, 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.

Assign CS extension code 80 [Systemic disease] for extramedullary plasmacytoma involving more than one site. Use code 80 when extramedullary plasmacytoma is NOT single, solitary, unifocal, isolated, mono-ostotic or localized. Code 80 can also be used when the bone marrow is involved but the plasma cells are <10%.

Do not apply EOD instructions to CS.

For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

 2009
20091081 Reportability/Histology--Brain and CNS: Is an "inflammatory myofibroblastic tumor" reportable for Brain and CNS sites? See Discussion. Histology code 8825/1 (Inflammatory Myofibroblastic Tumor) is not listed in the ICD-0-3 Primary Brain and CNS Site/Histology listing for reportable Brain/CNS tumors.

If the inflammatory myofibroblastic tumor is primary in one of the sites specified below and diagnosed 1/1/2004 or later, it is reportable.

Reportable brain and CNS tumors are any benign and borderline primary intracranial and CNS tumors with a behavior code of /0 or /1 in ICD-O-3 diagnosed 1/1/2004 and later, of the following sites:

  • Cerebral meninges C700
  • Spinal meninges C701
  • Meninges, NOS C709
  • Cerebrum C710
  • Frontal lobe C711
  • Temporal lobe C712
  • Parietal lobe C713
  • Occipital lobe C714
  • Ventricle, NOS C715
  • Cerebellum, NOS C716
  • Brain stem C717
  • Overlapping lesion of brain C718
  • Brain, NOS C719
  • Spinal cord C720
  • Cauda equine C721
  • Olfactory nerve C722
  • Optic nerve C723
  • Acoustic nerve C724
  • Cranial nerve, NOS C725
  • Overlapping lesion of brain and central nervous system C728
  • Nervous system, NOS C729
  • Pituitary gland C751
  • Craniopharyngeal duct C752
  • Pineal gland C753

 2009
20091023 Sugery of Primary Site--Breast: When a patient is simultaneously diagnosed with bilateral breast cancer and bilateral mastectomies are done, do you code the total mastectomies to 40 or 41 or 42?

Abstract cancer of the left breast and cancer of the right breast as separate primaries. Code the surgery for each primary independent of the other primary.

For the first primary, assign code 41 [Total (simple) mastectomy, NOS WITHOUT removal of uninvolved contralateral breast].

For the second primary, assign the code for the procedure performed on that site.

 2009
20091021

Behavior/Reportability--All sites: Would a GIST tumor stated to be "high risk for malignant behavior" be a reportable GIST? See Discussion.

According to our pathologist and oncologist, the terms "malignant" and "benign" do not apply to GIST. Rather, the term "high risk for malignant behavior" is used. This is based on tumor size: greater than 5 cm and mitotic activity: greater than 5 mitoses/50 hpf.

Do not report the case to SEER if it does not satisfy the criteria for reportability. According to the current reportability criteria, malignant GIST (8936/3) is reportable to SEER. GIST coded to 8936/0 or 8936/1 is not reportable. If your pathologist will not indicate "malignant" or "benign," code 8936/1 applies according to ICD-O-3 and, therefore, these are not reportable to SEER.

 2009