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Report Produced: 02/25/2026 07:28 AM

Report Question ID Question Discussion Answer Year
20081079 Ambiguous terminology/Reportability--Kidney: Is a case reportable if a biopsy diagnosis of "suggestive of oncocytoma, malignant neoplasm cannot be excluded" follows a CT scan that was read as "suspicious for carcinoma"? See Discussion. Pt is nursing home resident. CT abdomen/pelvis shows a "mass in the right kidney, highly suspicious for renal cell carcinoma". CT-guided needle biopsy performed with final diagnosis: "Neoplasm suggestive of oncocytoma. A malignant neoplasm cannot be excluded." No other information is available. This case is not reportable based on the information provided. The suspicious CT finding was biopsied and not proven to be malignant. "Suggestive of" is not a reportable ambiguous term. 2008
20081085 MP/H Rules/Histology--Colon: Per MP/H rule H3 for colon, code 8144/3 [Adenocarcinoma, intestinal type] should not be used with C180-C189 [colon]. However, page 58 of the ICD-O-3 SEER Site/Histology Validation list of February 9, 2001 lists code 8144/3 as a valid histology for large intestine. See Discussion. None of the errata have this site/histo combination. It is causing problems with researchers because pathologists still use the term: Adenocarcinoma, intestinal type for tumors of the large bowel. Please clarify or print errata.

For cases diagnosed 2007 or later:

This issue has been presented to the Edits work group. The preliminary response is that 8144/3 will be removed from the valid site/histology list for large intestine, small intestine, and rectum.

The edits based on the site/type list are used by many organizations. Any change to the site/type list is taken to the Edits work group.

 2008
20081026 MP/H rules/Multiple primaries: Is a 2007 cytology diagnosis of adenocarcinoma in bile duct a new primary for a patient with a 2005 diagnosis of adenocarcinoma of gallbladder? See Discussion.

A case abstracted for an adenocarcinoma of gallbladder (C23.9) in 2005. In 2007, cytology diagnosis of adenocarcinoma in bile duct(C24.0). Oncologist calls this recurrence. There is no pathologist statement of recurrence.

Using Other Sites multiple primary rules, rule M10 indicates this is multiple primaries. Sequence 01 dx in 2005 and sequence 02 dx in 2007. Is this correct? There is no statement of a primary tumor; the MP/H rules talk in terms of mass, lesion, tumor in a primary site.

 For cases diagnosed 2007 or later, abstract the 2007 bile duct diagnosis as a new primary unless it is described as metastatic. 2008
20081073

CS Extension/Ambiguous terminology--Pancreas: Should an exception be made for "abuts" or "encased/encasing" regarding CS pancreas extension? See Discussion.

According to the CS Manual regarding ambiguous terminology, we do not accept "abuts" or "encased/encasing" as involvement. According to the March/April 2008 issue of "CA, A Cancer Journal for Clinicians", vol 58, number 2, an article concerning Pancreas staging by M.D. Anderson researchers/clinicians recommends defining unresectable involvement of the celiac axis/mesenteric artery with the terms "abutment" as involvement of 180 degrees or less of the circumference of the vessel, and "encasement" as more than 180 degree involvement. A large comprehensive cancer center in our area has already adopted these guidelines.

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.Follow the current CS instructions regarding ambiguous terminology. "Abuts" and "encased/encasing" are not involvement.

The American College of Surgeons Commission on Cancer provided the following in response to this question: This concept can be considered for CS version 2, but it would need to be made in conjunction with acceptance of that same theory in AJCC 7th Edition so that the stage can be derived. Many times what can be defined and accepted in a closed environment of a single institution research project cannot be duplicated and accepted across the nation and in every community facility. Would pathologists specify the > or < 180 degree involvement in every pathology report? It would also have to be reviewed to see if this idea has been accepted by the larger oncology community, or just the idea of a single institution.

 2008
20081112 MP/H Rules--Breast: Is a 2008 invasive ductal carcinoma counted as a new primary when it follows a 2005 invasive lobular carcinoma diagnosed in the same breast? See Discussion. The patient has invasive lobular breast carcinoma excised in 2005. She returns in 2008 with a new invasive ductal carcinoma tumor same breast. Following MP/H rules, M10 seems to apply, which states this is still a single primary. Does this mean that this invasive ductal carcinoma is ignored and the patient remains in the registry with only a lobular carcinoma primary?

For cases diagnosed 2007 or later:

Rule M10 applies. The 2008 diagnosis is not a new primary.

The abstract for the 2005 diagnosis should be annotated to include the new information.

 2008
20081099 MPH Rules/Behavior--Breast: Would a positive right axillary node following DCIS of the right breast indicate the presence of a new primary? See Discussion. How would you abstract the information from 2007? A patient with a strong family history of breast cancer had bilateral simple mastectomies in 2000, after a suspicious mammogram. Results showed DCIS in the rt breast; no malignancy in the left breast. Now in 2007, the patient has a right axillary lymph node removed - positive for carcinoma of breast origin. Comment says, "recurrent breast carcinoma in rt axillary node from patient's known history of DCIS." Is this a new primary? Is this a diagnosis date in 2007? Is the site C509 and laterality right side?

For cases diagnosed 2007 or later:

A metastasis was diagnosed in 2007. The 2007 MP/H rules do not apply to metastases.

Change the behavior code of the 2000 diagnosis. The breast cancer diagnosed in 2000 must have been invasive based on the metastasis in 2007.

 2008
20081124

CS Extension--Brain and CNS: How is CS Extension coded for a malignant meningioma that demonstrates extension into adjacent brain tissue?

For malignant brain tumors, code 60 represents extension into the meninges. Would code 60 be the correct code for extension from a malignant meningioma into brain tissue?

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 60 for malignant meningioma with extension to adjacent brain tissue.

According to the I&R, this section of CS was taken directly from SEER Summary Staging, since AJCC does not have a staging system for these tumors.

 2008
20081063 MP/H Rules--Breast: How many primaries should be abstracted when a patient has a mass at 6:00 that showed poorly differentiated ductal carcinoma and a hypoechoic nodule at 9:00 that was excised with no real tumor present there though path showed angiolymphatic invasion by carcinoma throughout the entire specimen? See Discussion.

Palpable mass in right breast at 6:00. Path stated 'poorly differentiated ductal carcinoma with extensive necrosis and extensive angiolymphatic invasion. Focal high grade comedocarcinoma (1%)'. Another hypoechoic nodule was seen at the 9:00 position. This mass was excised from surrounding tissue. This mass was more like an inflammatory mass; there was no real tumor present there. Path report stated "Breast mass 9:00 excisional biopsy - angiolymphatic invasion by mammary carcinoma throughout the entire specimen."

Is this two primaries because of the two different histology codes: 8500 and 8010?

 For cases diagnosed 2007 or later, abstract as a single primary using rule M3 (a single tumor is always a single primary). There was one tumor present according to the information provided. The second specimen was not a separate tumor ("There was no real tumor present there"). 2008
20081004 First course treatment/Histology--Lymphoma: What treatment, if any, is coded for a patient with methotrexate induced lymphoma when the treatment plan is to take the patient off methotrexate? Also, is there a specific histology for drug induced lymphoma? See Discussion. Diffuse Large B-cell Lymphoma of soft palate & nasal septum, methotrexate induced, in 5/07. Patient was taken off methotrexate with complete resolution of disease. No other treatment was given. Patient was on methotrexate for treatment of rheumatoid arthritis.

For cases diagnosed prior to 1/1/2010:Treatment: Code the treatment fields to 00 [not done] in this case.

Document the discontinuation of methotrexate for rheumatoid arthritis in a text field.

Histology: Assign code 9680/36 [Malignant lymphoma, large B-cell, diffuse, NOS]. There is no specific histology code for therapy-related lymphoma.

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.

 2008
20081003 Reportability--Brain and CNS: For von Hippel Lindau disease with multiple hemagioblastomas, is each hemangioblastoma reportable as a new primary? See Discussion. Diagnosis of von Hippel-Landau disease, multiple brain surgeries between 2002 and 2007 for recurring hemangioblastomas, 9161/1. This disease manifests as multiple (recurring) hemangioblastomas.

For cases diagnosed 2007-2014:

If the hemagioblastomas occur in sites with different ICD-O-3 topography codes, they are separate primaries.

Please note: Rule M4 in the Benign & Borderline Intracranial and CNS Tumors MP/H coding rules on the SEER website has been corrected to read:

Tumors with ICD-O-3 topography codes that are different at the second (Cxx), third (Cxx) and/or fourth (Cxx) characters are multiple primaries.(http://www.seer.cancer.gov/tools/mphrules/benign_brain.html)

 2008