Primary Site--Testis: What is the prmary site for a 38 y/o male diagnosed with testicular cancer in a formerly undescended testis that was treated with orchiopexy at age 10-11? See discussion.
Surgery of Primary Site: What is the most extensive, invasive or definitive surgical procedure when the second surgical procedure performed has a lower surgery code? See discussion.
Surgery Primary Site--Breast: Please clarify how to code both simple mastectomy with tissue expander and AlloDerm reconstruction, and simple mastectomy with tissue expander (NOS). See discussion.
Multiple Primaries/Histology--Colon: What is the correct histology code and MP/H Rule when a colectomy final diagnosis is adenocarcinoma with colloid and signet ring cell features? See discussion.
Multiple Primaries/Behavior--Lung: When a patient has an invasive lung primary, how do in situ tumors of the lung affect the determination of multiple primaries? See discussion.
MP/H Rules/Histology: What is the proper histology code -- mucin producing adenocarcinoma or cholangiocarcinoma for the following case? See discussion.
Reportability--Skin: Is this case not reportable if the intranasal polyp is covered with cutaneous epithelium (essentially skin) or, is it reportable as a primary intranasal basal cell carcinoma? I have found one article regarding primary intranasal basal cells, which are described as being "very rare". But, I am not sure whether, in those cases, cutaneous epithelium was found.
FINAL DIAGNOSIS: (A) Nasal cavity, polyp, excision: Sinonasal inflammatory polyp with overlying cutaneous epithelium showing foci of superficial (noninvasive) basal cell carcinoma
Reportability/Behavior: Is the following reportable, and if so, what is the histology code? Final Diagnosis (on multiple conjunctive excisions): Conjunctiva - primary acquired melanosis with atypia (see note). Note: "In all 3 specimens the process extends to the margins of excision. Complete extirpation is recommended (primary acquired melanosis with atypia is considered melanoma in situ).