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Report Produced: 07/11/2025 15:08 PM

Report Question ID Question Discussion Answer Year
20140029

MP/H Rules/Histology-Urinary: 1) What is the correct ICD-O-3 morphology code for conventional renal cell carcinoma? Is this clear cell carcinoma or does conventional refer to the general diagnosis?

2) If a patient was diagnosed with invasive papillary urothelial carcinoma of the bladder in May 2011 and returns in February 2013 with invasive urothelial carcinoma of the bladder, what is the correct ICD-O-3 morphology code?

1) Clear cell renal carcinoma, code 8310, is often called conventional renal cell carcinoma. It is specific compared to renal cell carcinoma, NOS, code 8312, a general morphology term for the majority of kidney cancers. See  kidney rules H5 and H12 and Table 1 on page 57 of the Kidney Terms and Definitions, http://www.seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf

2) Do not change the ICD-O-3 code assigned for the 2011 diagnosis. As you know, the 2013 diagnosis is not a new primary per rule M6.

2014
20051073 Reportability/Behavior--Colon: Is a final diagnosis of "mucosal carcinoid" of the colon reportable with a behavior code 2 [in situ] or 3 [invasive] if the microscopic description states that a "malignancy is not appreciated"? See Discussion.

2002 carcinoid case. Path final diagnosis: sigmoid colon polyp, bx-- sm mucosal carcinoid (1.5mm) w/crush artifact in a colonic polyp showing assoc inflammatory and hyperplastic changes. Micro: due to prominent crush artifact, histologic detail is compromised; however, significant atypia or malignancy is not appreciated.

Our state registry requests that this case be abstracted using the histology code 8240/3 because it is a mucosal carcinoid.

AJCC states TIS as being confined w/i basement membrane w/no extension through muscularis mucosae into submucosa. SEER-EOD codes as invasive: mucosa, lamina propria and muscularis mucosae. Our pathologist goes along with AJCC while we are having to code with SEER rules.

1) Assign /3 to mucosal carcinoid, unless stated to be in situ in the final diagnosis. ICD-O-3 is the reference for assigning the behavior code, not AJCC, EOD or CS.

2) The ICD-O-3 code for carcinoid of the sigmoid colon is C187 8240/3. This is reportable to SEER based on the final diagnosis above. Use the histology stated in the final diagnosis.

 2005
20130189

Reportability--Brain and CNS: Are the terms 'mass' and 'lesion' reportable terms for accessioning brain and CNS primaries? See Discussion.

With respect to reportability, the SEER Manual mentions 'tumor' and 'neoplasm,' but not 'mass' or 'lesion.' The SEER MP/H Manual states tumor, mass, lesion and neoplasm are equivalent terms for determining multiple primaries, but does this apply to reportability? If not, what is the distinction?

'Mass' and 'lesion' are not reportable terms for benign/borderline brain and CNS tumors.

Reportable terms for benign/borderline brain and CNS primaries are 'tumor' and 'neoplasm.' These terms appear in the ICD-O-3. 'Lesion' and 'mass' do not appear in the ICD-O-3. Do not use the MP/H Manual to determine reportability; page 2 of the SEER Manual is the correct source for reportability instructions.

 2013
20150001

Reportability/Histology: Would a histology reading "Well-differentiated neuroendocrine neoplasm" of the appendix be reportable? Since the word "tumor NOS" and "neoplasm NOS" both code to 8000, I would assume they would be interchangeable but just wanted to verify.

According to SINQ 20130027 & 20140002 a "Well-differentiated neuroendocrine tumor" of the appendix IS reportable.

"Well-differentiated neuroendocrine neoplasm" of the appendix is reportable. According to the WHO classification of Digestive System Tumors, "Well-differentiated neuroendocrine neoplasm" of the appendix is synonymous with NET. WHO states on page 13 "The term 'neuroendocrine neoplasm' can be used synonymously with 'neuroendocrine tumor.'"

Neuroendocrine "tumor," or NET G1, is listed in the WHO classification as one of the malignant neoplasms of the appendix.

 2015
20081033 Ambiguous terminology: Is the phrase "malignancy is highly considered" reportable given that the phrase "considered to be malignant" is reportable per SINQ 20061094?

"Malignancy is highly considered" is not a reportable ambiguous term.

Diagnoses qualified by the phrase "considered to be malignant" are reportable because this phrase is interpreted as "This diagnosis is malignant."

 2008
20051079

Reportability/AmbiguousTerminology: Because there is a caveat in the SEER PCM, 3rd edition to ignore adverbs such as "strongly" when assessing reportability, should a term such as "likely" cancerous be reportable given than the expression "most likely" cancerous is reportable?

"Likely cancerous" is NOT reportable.

The CoC, NPCR and SEER have agreed to a strict interpretation of the ambiguous terms list. Terms that do not appear on the list are not diagnostic of cancer.

 2005
20150014

Reportability--Brain and CNS:  Is "Lhermitte-Duclos disease" is reportable? See discussion.

The MRI states "Lhermitte-Duclos disease" but does not include "dysplastic gangliocytoma of cerebellum"; is this the same as "Lhermitte-Duclos dysplastic gangliocytoma of cerebellum (C716)"?

"Lhermitte-Duclos disease" alone can be interpreted as "Lhermitte-Duclos dysplastic gangliocytoma of cerebellum (C716)" and reportable. The WHO classification for CNS tumors lists this entity as "Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease)" signifying that the terms are used synonymously.

2015
20140070

Reportability--Pancreas: Is this reportable? Is this benign? If reportable, what histology code and behavior code should be used? A final pathology diagnosis reads: "Cystic pancreatic endocrine neoplasm (CPEN)".

"Cystic pancreatic endocrine neoplasm (CPEN)" is reportable. Assign 8150/3 based on the information provided. We consulted our expert pathologist and he states "Since metastases have been reported in a few, and all the rest of the pancreatic endocrine tumors are now designated malignant, …we are safe considering them /3 until proven otherwise. Since most of them are non-functioning, [assign code] 8150/3 unless specified as to G1 (8240/3) or G2 (8249/3)."

2014
20110073 MP/H Rules/Multiple primaries--Sarcoma: Does a prior clinical diagnosis of a metastatic deposit for a previously diagnosed sarcoma have priority if the diagnosis on a subsequent resection (18 months later) indicates it is also a sarcoma but does not state it represents metastasis from the original sarcoma primary? See Discussion.

1/28/08 Patient was diagnosed with spindle cell sarcoma in the right gluteus muscle. Metastatic tumors were found in a vertebral body and in the lung. Chemotherapy was started.

4/22/08 PET scan done to evaluate response to chemo. The primary tumor had increased in size. New mass in the left thigh that was highly suspicious for metastasis found. (The left thigh tumor was not accessioned at that time as it was described as a metastatic tumor.)

7/3/09 Left thigh tumor was resected and path revealed spindle cell sarcoma. There was no mention that it represented metastasis.

Does the left thigh tumor represent a new primary per rule M12? Or does the previous clinical description of the left thigh tumor representing metastasis have priority?

this is a single primary per Rule M1. According to our expert pathologist, "if multiple solid tissue tumors are present (sarcomas), then almost always there is one primary and the rest are metastases. There are infrequent occasions of multifocal liposarcoma or osteosarcoma occurring, but the patient would be treated as a patient with metastatic disease."

The steps used to arrive at this answer are:

Open the Multiple Primary and Histology Coding Rules manual. For a soft tissue primary, use one of the three formats (i.e., flowchart, matrix or text) under the Other Sites MP rules to determine the number of primaries because soft tissue primaries do not have site specific rules.

Go to the UNKNOWN IF SINGLE OR MULTIPLE TUMORS module, Rule M1.

Rule M1 states, "It is not possible to determine if there is a single tumor or multiple tumors, opt for a single tumor and abstract a single primary." Given the information from the expert pathologist, this case should be reported as a single primary applying this rule.

2011
20230055

Reportability/Histology--Heme and Lymphoid Neoplasms: Is "the differential diagnoses include, but not limited to, mantle cell lymphoma, atypical chronic lymphocytic leukemia/small lymphocytic lymphoma and a variant of marginal zone lymphoma" reportable? In the Heme manual, they use differential diagnosis that include reportable conditions as reportable. This can be found under Code 1: positive histology in the Diagnostic Confirmation Coding Instruction section page 18. The phrase "include, but not limited to" makes this not clear. 

This is reportable as 9591/3, B-cell lymphoma, NOS.All diagnoses in the differential are all B-cell lymphomas. The pathologist knows it a B-cell lymphoma but has not determined the subtype. If at a later time a specific lymphoma is determined, update the histology code accordingly. 

 2023