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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."Matted" is not a synonym for "Fixed" in the CS schema for Head and Neck. "Matted" is not indicative of extracapsular extension for the Head and Neck schema.

For cases diagnosed 2007 or later:

The May 2008 diagnosis is not a new primary. Base of tongue involvement was originally present in August 2007. The May 2008 diagnosis does not represent new tumor. The 2007 rules apply to new tumors only; therefore, the 2007 rules do not apply to this case.

In this case, neither the chemoembolization nor the liver transplant is part of the first course of therapy. The documented treatment plan was changed after disease progression. Chemoembolization was not part of the original treatment plan. First course therapy ends at this point.

For cases diagnosed 2007 or later, this case is a single primary. The chest wall (NOS) is a metastatic site for breast cancer. There is no mention of residual breast tissue, so the 2008 diagnosis cannot be a new primary.

"Chest wall" is an ambiguous term. It can mean the internal chest wall or the external chest wall. When the path report states that the "recurrence" is in residual breast tissue, this is most likely the external chest wall and the residual breast tissue is part of the breast not removed by the MRM. In contrast, skin or the chest wall, NOS, are regional metastases.

For cases diagnosed 2007 or later, assign 8077/2 [Squamous intraepithelial neoplasia, grade III] for VIN III diagnoses, regardless of the type. According to the WHO Classification of Tumours (page 319), "VIN is predominately of the warty or basaloid types...."

Use the multiple tumors module to determine the histology code for VIN. Rule H21 applies.

For cases diagnosed 2007 or later:

Use the 2007 MP/H rules for urinary sites to assess tumors diagnosed in 2007 or later.

For the example above, use the 2007 rules to determine whether or not the bladder tumor diagnosed in 2007 is a new primary. Use the Multiple Tumors module when comparing a 2007 or later diagnosis to an earlier diagnosis. Start with rule M3. Stop at rule M8. The 2007 bladder urothelial tumor is not a new primary since there is an existing 2006 renal pelvis urothelial primary.

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.

Lymph nodes in the mesentery of the sigmoid colon are regional for an ovarian primary. Code involved sigmoid mesenteric nodes under CS Lymph Nodes.

For cases diagnosed 2007 or later, assign histology code 8503 [Papillary adenocarcinoma]. Rule H14 applies.

ICD-O-3 code 8050 does not apply in this case. Refer to the numeric listing in ICD-O-3. 8050 is a squamous cell neoplasm. Papillary carcinoma of the breast is NOT a squamous cell neoplasm. It is a neoplasm of the breast parenchyma - ducts, lobules or connective tissue. 8503 is the correct code in this case.

For cases diagnosed 2007 or later:

Use the 2007 MP/H rules for urinary sites to assess diagnoses made in 2007-2014. Use the multiple tumors module to compare a diagnosis in 2007-2014 to an earlier diagnosis.

For the example above, start by comparing the left renal pelvis diagnosis in 8/07 to the earlier left ureter primary diagnosed 5/05. Start with rule M3. Stop at rule M8. The 8/07 renal pelvis diagnosis is not a new primary. Next, compare the 3/08 bladder tumor to the earlier left ureter primary diagnosed 5/05. Start with rule M3. Stop at rule M5. The 3/08 bladder tumor is a new primary because it is an invasive diagnosis following an in situ diagnosis. Use only the more recent of the two earlier urinary diagnoses for comparison. Do not compare the 2007 and later diagnoses to the 11/89 in situ bladder primary in this case.