Reportability--Brain and CNS: Is "Lhermitte-Duclos disease" is reportable? See discussion.
The MRI states "Lhermitte-Duclos disease" but does not include "dysplastic gangliocytoma of cerebellum"; is this the same as "Lhermitte-Duclos dysplastic gangliocytoma of cerebellum (C716)"?
"Lhermitte-Duclos disease" alone can be interpreted as "Lhermitte-Duclos dysplastic gangliocytoma of cerebellum (C716)" and reportable. The WHO classification for CNS tumors lists this entity as "Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease)" signifying that the terms are used synonymously.
Reportability--Brain and CNS: Is an MRI finding of “statistically meningioma” reportable? See Discussion.
Example: Patient has a 2023 brain MRI described as having a “new dural based nodule, statistically meningioma, along the left distal tentorial incisura.” All subsequent chart information is related to patient’s unrelated diagnosis of multiple sclerosis only.
Is the terminology “statistically” reportable ambiguous terminology in this context?
If you cannot clarify this with the involved physicians, do not report this case of meningioma based on information provided. There is no indication that the patient was treated or further evaluated for meningioma.
Reportability--Brain and CNS: Why has reportability changed for "intradural extramedullary schwannomas"? Are all "spinal" schwannomas reportable or only those stated to be "intradural"? See Discussion.
If intradural schwannomas are to be collected for cases diagnosed 2011 and later, why were they not included in the 2012 SEER Manual? Should collection of spinal schwannomas be postponed until the next revision of the MP/H Rules?
The reportability of schwannomas was not initially agreed upon by the standard setters. After the issue was discussed by the CoC, NPCR and SEER Technical Workgroup and an agreement was reached. See #2 under Reportability in the Data Collection Answers from the CoC, NPCR, SEER Technical Workgroup http://www.seer.cancer.gov/registrars/data-collection.html#reportability.
The most accurate and most current instruction is to report these spinal tumors when they arise within the spinal dura or spinal nerve roots, or when they are stated to be "intradural" or "of the nerve root." Do not report these tumors when they arise in the peripheral nerves. The peripheral nerves are the portion of nerve extending beyond the spinal dura.
Spinal cord intradural schwannomas originate in spinal nerve roots. Spinal nerve root is best classified as spinal cord, C720.
Reportability--Brain and CNS: Is Tuberculum sellae meningioma reportable? Is it same as sphenoidale meningioma?
Path: Brain tuberculum tumor resection: Meningioma, WHO grade I.
Revised answer based on ST rules
Yes, a Tuberculum sella meningioma is reportable if diagnosed 2004 or later. Code the primary site C700, cerebral meninges. It is a meningioma originating from the meninges of the Tuberculum sellae, which is part of the sphenoid bone.
Reportability--Brain and CNS: Is this diagnosis reportable? If this neoplasm originated in the spinal cord, it is reportable, correct?
Specimen is described as a 'spinal cord mass.' The final diagnosis is 'fragments of adipose tissue demonstrating vascular proliferations consistent with angiolipoma. No histologic evidence of malignancy.' The microscopic description says: Sections of the spinal mass reveal bone, cartilage, fibrous tissue and adipose tissue. The adipose tissue demonstrates increased vascularity with thin walled blood vessels seen with islands of delicate fibrous stroma. The histologic findings are compatible with fragments of angiolipoma.
The neoplasm is reportable if it originated in the spinal cord or is intradural (within the spinal dura; spinal nerve roots are intradural). If there is not enough information to determine the exact site of origin, do not report the case.
Reportability--Brain and CNS: Is schwannoma of the extracranial part of a cranial nerve reportable? Some cranial nerves, like facial nerve, have intracranial and extracranial branches.
An extracranial schwannoma is not reportable. The schwannoma must arise on the intracranial part of the nerve to be reportable.
Reportability--Brain and CNS: Is Rosai-Dorfman disease a neoplastic reportable disease process if it occurs in the brain? See Discussion.
The pathology report diagnosis is: Cranium, right temporal area, resection of intradural, extra-axial mass: Severe acute and chronic inflammation, histiocytic reaction, and proliferative fibrosis. See comment.
Comment: Among potential alternative considerations are an infectious process, or non-infectious inflammatory CNS lesions such as inflammatory pseudotumor, Rosai-Dorfman disease, plasma cell granuloma, idiopathic hypertrophic pachymeningitis, and inflammatory myofibroblastic tumor.
The clinicians discuss this and review other chart information and conclude the patient has a clinical diagnosis of Rosai-Dorfman disease.
This is a rare disorder characterized by proliferation of histiocytes.
This case is not reportable. Rosai-Dorfman disease is not listed in the ICD-O-3. To be reportable, a neoplasm must be listed in the ICD-O-3 and originate in a reportable brain/CNS site.
Reportability--Brain and CNS: Is pseudotumor cerebri reportable?
Pseudotumor cerebri is not reportable. It is not a neoplasm. The pressure inside the skull is increased and the brain is affected in a way that appears to be a tumor, but it is not a tumor.
Reportability--Brain and CNS: Is meningioangiomatosis reportable as meningiomatosis (9530/1) or angiomatous meningioma (9534/0)? See Discussion.
Pathology report: Brain tumor, left side: Gliotic cortex and subcortical white matter with meningioangiomatosis (see Comment). Comment This specimen represents a meningioangiomatous lesion located in the leptomeninges that projects along the Virchow-Robin spaces into the underlying cortex. The surrounding brain parenchyma demonstrates reactive changes with astrogliosis and microgliosis. An intraparenchymal neoplasm is not seen. Meningioangiomatosis is a rare benign meningovascular hamartomatous condition and usually appears in young patients.
Meningioangiomatosis is not reportable. It is a cortical lesion which may occur sporadically or in NF2 (neurofibromatosis type 2). It is not listed in ICD-O-3.
Reportability--Brain and CNS: Is hygroma reportable? See Discussion.
Benign brain guidelines indicate that named tumors that have been assigned an ICD-O-3 code are reportable. However, per I&R: "Most cystic hygromas (9173/0) are fetal malformations and occur in patients less than two years old. If this patient was an adult, they are primarily treated with surgery. Hygroma (used in a general sense) is a response to trauma (i.e., subdural hematoma) and as such, is not a "new growth" and would not be reportable either as a cyst or as a neoplasm. Unless the patient had some sort of operation, I'd hesitate to include the case as a reportable benign tumor."
How is the cancer registrar to distinguish between reportable and non-reportable hygromas? Example: Brain MRI showed diffuse cerebral volume loss and incidental bilateral frontal subdural hygromas (histology code 9173/0).
Reference: I&R 14825
Hygromas are not reportable. This instruction will be added to the next revision of the benign brain rules.
According to an expert in the field, hygromas are not neoplastic. Hygromas are cystic dilations of a localized subarachnoid or subdural accumulation of clear fluid related to an excess accumulation of CSF, typically related to an old hemorrhage that somehow prevents reabsorption of CSF.
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