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Report Produced: 12/23/2025 01:14 AM

Report Question ID Question Discussion Answer Year
20180097

Reportability/Histology--Liver: Are primary hepatic neuroendocrine neoplasm and primary hepatic neuroendocrine tumor (PHNET) reportable? What are the specific histology codes?

Primary hepatic neuroendocrine tumor (PHNET) is reportable as are other digestive system NETs. There is no specific histology code for PHNET. We suggest you assign 8240/3. Use text fields to document the details.

Unless you can obtain clarification, do not report primary hepatic neuroendocrine neoplasm with no further information. If this term is being used as a synonym for PHNET, document this in the registry's policies and procedures, and report these cases.

 2018
20180113

Solid Tumor Rules (2018)/Histology--Lung: What is the histology code of a 2018 lung cancer case with invasive non-mucinous adenocarcinoma? For non-mucinous carcinoma/adenocarcinoma, the Solid Tumor Rules have codes for microinvasive, minimally invasive, preinvasive, and in situ. Do we default to the microinvasive/minimally invasive code?

Code histology to adenocarcinoma, NOS (8140/3). The World Health Organization and the College of American Pathologists no longer recognize non-mucinous carcinoma/adenocarcinoma, NOS. Pathologists are discouraged from using this term. Microinvasive/minimally invasive lung tumors have very specific criteria and these criteria do not apply to non-mucinous carcinoma, NOS.

 2018
20180082

Summary Stage Manual 2018 "Lymphoma: SEER Summary Stage 2000 states: For lymphomas, any mention of lymph nodes is indicative of involvement and is used to determine the number and location of lymph node chains involved (see lymphoma scheme). This statement is not in SEER Summary Stage 2018. Does that mean we follow rules #4-7, pages 14-15, under Code 3: Regional Lymph Nodes only, for every site, including lymphoma?

The following statement "Any mention of the terms including fixed, matted, mass in the hilum, mediastinum, retroperitoneum, and/or mesentery, palpable, enlarged, shotty, lymphadenopathy are all regarded as involvement for lymphomas when determining appropriate code," is included in EOD Primary Tumor and is applicable to Summary Stage 2018.

The statement will be added as note 4 to the Lymphoma Summary Stage chapter. This will be included in the 2019 update (estimated release January 2019).

 2018
20180022

Reportability/Histology: Is a focal high grade squamous intraepithelial lesion (HSIL/moderate to severe dysplasia/VIN II-III) in the vulva reportable for cases diagnosed in 2018? See discussion.

Since high grade squamous intraepithelial lesion (HGSIL) is reportable for the vulva in 2018 (per SINQ 20130185) but VIN II-III is not reportable, we need to clarify this reporting format seen in our area.

Report when stated to be high grade squamous intraepithelial lesion of the vulva. The 2018 SEER Manual says to assign 8077/2. HGSIL is a synonym for squamous intraepithelial neoplasia, grade III for vulva and vagina only.

 2018
20180018

MP/H Rules/Histology--Brain and CNS: How should histology be coded for the following 2017 cases (pituitary adenoma vs. prolactinoma)? See Discussion.

1. (2017) Pituitary mass resection with a path diagnosis of

Do we code as prolactinoma when the tumor is immunoreactive for prolactin or must there be a definitive statement of ?

2. (2017) Pituitary lesion on imaging, MD diagnosis of

Current (2007) MP/H rule H9 states when there are multiple histologies in the same branch in Chart 1, code the more specific histology. These histologies are NOT in Chart 1, but prolactinoma seems to be a more specific type of pituitary adenoma. The next rule, H10 states to code the numerically higher code, 8272/0 (pituitary adenoma)?

3. (2017) Imaging diagnosis of pituitary macroadenoma with clinical diagnosis by MD of macroprolactinoma.

Current rules indicate when there is no path specimen that physician reference to type of tumor has priority over imaging.

Will these answers/histologies change with the upcoming 2018 Solid Tumor rules?

Code each of these 2017 cases as prolactinoma (8271/0), the more specific histology.

If these cases were diagnosed in 2018, the answer would be the same: code as prolactinoma.

 2018
20190029

Reportability--Testis: Is demarcated scar tissue with atrophic seminiferous tubules and cortical bone consistent with burnt-out germ cell tumor and no evidence of germ cell neoplasia in situ (GCNIS) reportable? See Discussion.

The patient is a 34 year old who presented with testicular pain radiating into the abdomen approximately 1 month before orchiectomy in 2018. CT abdomen/pelvis: Multiple focal sclerotic bone lesions. Given the lack of change from July 2014, these are likely benign bone islands. No adenopathy mentioned. He has no prior history of germ cell tumor nor any surgery for any tumor/cancer before this. Pathology: Testis, left, radical orchiectomy: - Demarcated scar tissue (1.3 cm), with atrophic seminiferous tubules and cortical bone consistent with burnt-out germ cell tumor. No evidence of germ cell neoplasia in situ (GCNIS). - Margins are unremarkable.

Burnt-out germ cell tumor (9080/1) is not reportable. According to WHO Classification of Urinary System and Male Genital Organ, regressed germ cell tumors are germ cell tumors that have undergone partial or complete regression leaving a generally well-delineated nodular focus of scar or fibrosis in the testis.

 2019
20190067

Reportability/Histology--Breast: Is a breast mastectomy showing mildly atypical cells within the nipple epidermis which are suspicious for Paget disease of the nipple a reportable malignancy? See Discussion.

Example: Left breast total mastectomy final diagnosis is incidental microscopic findings suspicious for early Paget disease of the nipple. The diagnosis comment states: The left breast mastectomy shows mildly atypical cells within the nipple epidermis which are suspicious for early Paget disease of the nipple. Additional sampling of the left breast was performed, and no evidence of atypical hyperplasia, in situ carcinoma, or invasive carcinoma within the left breast tissue was identified.

Would this case be non-reportable using rationale similar to an early/evolving melanoma per SINQ 20180029?

Code as 8540/3, Paget disease, based on the use of reportable ambiguous terminology (suspicious) listed in the 2018 SEER Coding Manual. In addition, Rule H8 of the 2018 Breast Solid Tumor Rules says to code Paget disease (8540/3) when the diagnosis is exactly Paget disease when a new tumor with no underlying tumor and the pathology documents invasive or unknown behavior.

When two ambiguous terms are used and one is on the reportable list (suspicious) and one is not (early), accept the reportable term and report the case. See #1.b.ii on page 12 in the SEER manual, https://seer.cancer.gov/manuals/2018/SPCSM_2018_maindoc.pdf

 2019
20190041

Reportability/Primary Site--Gastrointestinal (GI) Tract: Is a gastrointestinal stromal tumor (GIST) with a single nodule in the small intestine (C17_) and a nodule in the stomach (C16_) reportable per the 2018 SEER Coding Manual reporting instructions for GIST due to the multiple foci or do the multiple foci need to be in the same organ to be reportable? See Discussion.

Example: Small intestine wedge resection with GIST, 1.8 cm in mid small intestine, single nodule. Stomach nodule biopsy: GIST, 0.3 cm. Pathology report comment section indicates the gastric GIST is not staged due to the small size and incidental nature.

Report the GIST in the small intestine. The 2018 SEER Manual says to report GIST when there are multiple foci and to code the primary site to the site where the malignancy originated. Use text fields to record the details, including the stomach nodule.

 2019
20190075

Sex: How should the sex field be coded for the newly allowable non-binary gender designation ? See Discussion.

Washington State added to birth certificates, which allows people to have their certificates changed to this non-binary gender designation. Gender X is defined as a gender that is not exclusively male or female, including, but not limited to: intersex, agender, amalgagender, androgynous, bigender, demigender, female-to-male, genderfluid, genderqueer, male-to-female, neutrois, nonbinary, pangender, third sex, transgender, transsexual, Two Spirit, and unspecified.

Code Gender X as 9 when that is the only information available. Use text fields to document the details.

Also refer to coding instruction #7.

When gender is not known

Assign code 1 when the primary site is C600 'C639

Assign code 2 when the primary site is C510 'C589

Assign code 9 for primary sites not included above

 2019
20190090

Update to current manual/EOD 2018/Summary Stage 2018--Fallopian Tube: How are behavior, EOD Primary Tumor, and Summary Stage 2018 coded for a diagnosis of serous tubal intraepithelial carcinoma (STIC) of the fallopian tube? See Discussion.

The 2018 ICD-O-3 Histology Updates table lists serous tubal intraepithelial carcinoma (C57.0) with a behavior code of 2.

The EOD Primary Tumor schema for Fallopian Tube shows STIC has an extension code of 100. It also maps code 100 to Summary Stage 2018 L (localized).

Summary Stage 2018 for fallopian tube only documents that intraepithelial tumors are summary stage 0 (in situ).

We are aware of the issue and have been in discussion with standard setters (SEER, NPCR, AJCC, and NAACCR). At this time, we recommend coding:

Histology: 8441/2

Extent of Disease (EOD) Primary Tumor: 000

Summary Stage: 0

AJCC Clin/Path T would be 88, since all in situ lesions are not applicable.

Edits will not allow you to have a 8441/2 with a T1. Also, EOD is not currently set up to derive the correct T value, unless you code 100.

The change to address the issue will take effect in 2021.

 2019