Solid Tumor Rules (2018)/Multiple Primaries--Lung: How many primaries should be reported when a patient has a 7/2016 diagnosis of right lower lobe lung mucinous adenocarcinoma, treated with Erlotinib and Avastin? In 4/2020, a liver biopsy finds metastatic high grade neuroendocrine carcinoma, clinically stated to be metastatic lung cancer, with no evidence of a new primary lung tumor on PET (liver the only site of disease)? See Discussion.
Solid Tumor Rules (2018)/Multiple primaries--Lung: How many primaries should be reported for a patient with a March 2018 diagnosis of non-small cell carcinoma with neuroendocrine differentiation on lung biopsy (single left upper lobe tumor only) who also has a prior history of left lung squamous cell carcinoma in 2016 (treated with chemotherapy/radiation)? See Discussion.
Solid Tumor Rules (2018)/Multiple primaries--Lung: How many primaries are there and what M rules apply for multiple lung histologies in the left lower lobe (LLL) and right upper lobe (RUL) of the lungs? See Discussion.
Solid Tumor Rules (2018)/Multiple primaries--Lung: How are Primary Site and EOD Primary Tumor coded when a patient is diagnosed with four invasive tumors in the right lung that represent three separate primaries, but the not otherwise specified (NOS) tumor and one of the specific subtype/variants are in separate lobes? See Discussion.
Solid Tumor Rules (2018)/Multiple primaries--Liver: When does a hepatocellular carcinoma (HCC) recurrence in the same area of the liver get accessioned as a new tumor following TACE/Y90/RFA? If there is a new HCC in the same area as previously treated but it is stated to be recurrent and/or progressive disease, is that evidence of a disease-free interval? If the tumor area is stated to be LR-TR and non-viable, but then a new HCC in that area is diagnosed, does that count as a disease-free interval? See Discussion.
Solid Tumor Rules (2018)/Multiple Primaries--Head & Neck: How many primaries are accessioned when a patient is diagnosed with right nasal cavity (C300) invasive nonkeratinizing squamous cell carcinoma (8072/3) in 2015 treated with radiation and excision, followed by a 2019 right nasal cavity (C300) invasive squamous cell carcinoma (NOS, 8070/3)? See Discussion.
Solid Tumor Rules (2018)/Multiple Primaries--Head & Neck: How many primaries are accessioned and what M Rule applies when a patient is diagnosed with a right lateral tongue (C023) tumor in 2016 that was verrucous carcinoma (8051), followed by a new left tongue border (C021) tumor in 2019 that was squamous cell carcinoma, NOS (8070)? See Discussion.
Solid Tumor Rules (2018)/Multiple primaries--Corpus uteri: How many primaries are accessioned for patient with a minimally invasive endometrial adenocarcinoma arising in a polyp in 2001, followed by a metastatic poorly differentiated clear cell carcinoma of gynecologic (GYN) origin in 2019? See Discussion.
Solid Tumor Rules (2018)/Multiple primaries--Colon: Solid Tumor Rules 2018, Colon Rule M7, bullet 3 indicates that (if neither bullet 1 or 2 apply) a new tumor at the anastomotic site must be stated to arise in the mucosa (confirmed in SINQ 20190096) to qualify as a new primary. However, there is often no clear statement of tumor arising from or involving mucosa (unless the new tumor is limited to the mucosa) noted by pathologists in our region. Do any of the following examples imply a new tumor arising in mucosa per Rule M7, bullet 3? See Discussion.
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