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Report Produced: 10/07/2026 12:22 PM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20130190

Reportability: Is a thymoma, type B3 malignant and, therefore, reportable? See Discussion.

Recent information received from a registrar/pathologist states the WHO classifies well-differentiated thymic carcinoma [8585/3] as a synonym for type B3 thymoma.

For cases diagnosed prior to 2021

Thymoma, type B3 [8585/1] is not reportable. Well-differentiated thymic carcinoma [8585/3] is reportable.

WHO lists well-differentiated thymic carcinoma as a synonym for type B3 thymoma, but indicates the behavior code differs as indicated above.

See the applicable SEER manual for cases diagnosed 2021 and later.

 N/A N/A 2013
20081075 Race, ethnicity/Spanish surname or origin: SEER Program Manual instructions state, "Portugese, Brazilians and Filipinos are not Spanish; Code non-Spanish (code 0)." How is that determined? Is that based SOLELY on birthplace? See Discussion.

The following are scenarios for which we would like clarification on how to code Spanish Ethnicity.

  • Birthplace Portugal; text states Spanish, south American or European Spanish

  • Birthplace Brazil, last name is on Spanish surname list; pt is married female. Text states "Hispanic female, NOS"

  • Birthplace Brazil or Portugal, text states patient is "Mexican", last name is on Spanish surname list

    • Information about Spanish origin is available for both of these cases; code the race as Hispanic. Use the SEER manual instruction when the only information available is that the patient was born in Portugal, Brazil or the Philippines. In the absence of additional information, do not assume Hispanic. However, if additional information is available stating that the patient is Hispanic, code as Hispanic.

    Spanish Surname or Origin Scenarios

  • 6 [Spanish, NOS; Hispanic, NOS; Latino, NOS]

  • 6 [Spanish, NOS; Hispanic, NOS; Latino, NOS]

  • 1 [Mexican (includes Chicano)]

    		• N/A Race, ethnicity 2008
    		20071045 Ambiguous Terminology: How is this field to be coded when there is a "conclusive term" exactly 60 days following the initial diagnosis? See Discussion. Is code 1 [Ambiguous terminology diagnosis only within 60 days of initial diagnosis] or code 2 [Ambiguous term followed by a conclusive term more than 60 days after the initial diagnosis] to be used for a case that had a conclusive diagnosis at 60 days from initial diagnosis? The instructions on page 97 do not match the code definitions on page 95.

    The definition for code 2 should be "More than 60 days" after the date of diagnosis.

    Code 1 is 60 days or less, code 2 is more than 60 days.

    This will be clarified in the first revision to the MP/H manual.

    		 N/A N/A 2007
    		20100026 Multiplicity Counter--Kidney, Renal Pelvis: How many times is this field updated after an invasive primary is originally diagnosed? Should subsequently diagnosed in situ tumors to be included in this field? See Discussion. How should the Multiplicity Counter be coded when a patient has a renal pelvis primary [C659] diagnosed 1/23/08. The patient had one tumor, invasive grade 3 of 3 papillary urothelial carcinoma arising in the depth of a calyx in mid portion of kidney. In 6/1/09, a TURBT showed three separate high grade urothelial carcinoma in-situ lesions on the right side of the bladder, the largest tumor being 7mm. In 2/8/10, another TURBT showed one lesion on the left side of bladder, high grade urothelial carcinoma in-situ, tumor was 4mm. These are all a single primary per rule M8.

    Code multiplicity counter 04. Count both invasive and in situ tumors.

    Multiplicity counter would have been coded 01 in 2008. Add the three in situ tumors diagnosed in 2009 to the first tumor and update multiplicity counter to 04. Make only one update to multiplicity counter. Because the multiplicity counter was updated once, the fifth tumor diagnosed in 2010 does not need to be added.

    		N/A N/A 2010
    		20100050

    Reportability--Colon: Would a carcinoid tumor, NOS, of the appendix with perineural or angiolymphatic invasion be reportable if there is no mention of malignancy in the pathology report?

    Carcinoid, NOS, of the appendix diagnosed in 2015 or later is reportable.

    For cases diagnosed prior to 2015

    Carcinoids of the appendix are reportable when they meet any of the following conditions.

  • The pathologist designates the carcinoid as malignant

  • Regional lymph nodes are positive for MALIGNANT carcinoid (not reportable if lymph nodes are reported to be involved with benign carcinoid disease)

  • There are discontinuous metastatic implants or involvement

    • Note that the implants/involvement must be designated as malignant. Many benign tumors will spawn implants that are also benign. If implants are benign, this is not a reportable tumor.

    		N/A N/A 2010
    		20120060 Primary Site/Reportability: What is the primary site and reportability status of a "pancreatic endocrine neoplasm" that arises in the heterotopic pancreas of the splenic hilum that is stated to be a "well-differentiated endocrine tumor, uncertain behavior per the WHO classification"? See Discussion.

    SINQ 20120035 states that well differentiated pancreatic endocrine neoplasms should be reported with histology code 8240/3. However, the pathology report provides the WHO Classification which states "uncertain behavior." Should this tumor still be reported as 8240/3?

    If reportable, how is the primary site coded? The tumor arose in heterotopic pancreas (in the splenic hilum), which is pancreatic tissue found outside the usual anatomical location of the pancreas. Per the pathology report, the tumor did not invade the spleen. Should the primary site be coded to C48.1 [mesentery]? The patient is female and the coding schema for "Peritoneum for Females" would apply to the case. However, none of those CS extension codes seem to apply to this localized case.

    This case is reportable. Code the primary site to C25.9 [pancreas, NOS] and the histology to 8240/3 [neuroendocrine tumor (NET), Grade 1].

    Per the 2012 SEER Manual, code the site in which the primary tumor originated. This neoplasm arose in pancreatic tissue and will behave accordingly, even though this pancreatic tissue is not located in the usual place.

    Pancreatic endocrine and neuroendocrine neoplasms are essentially the same thing. However, they are described in two different WHO classifications; the endocrine classification and the digestive system classification. The digestive system classification is more recent, and is preferred by our expert pathologist consultant. The term "neuroendocrine" is to be used now, rather than "endocrine." In the pancreas, "well differentiated endocrine tumor" is synonymous with "neuroendocrine tumor (NET) Grade 1" and is coded 8240/3.

    		N/A Primary site 2012
    		20100058 Grade: Can the nuclear grade value be coded in the grade field for any site, or is it restricted to sites where it is specifically listed as an option in the coding manual, i.e., breast, kidney, urinary sites, etc.? There is no restriction on sites for which nuclear grade can be coded in the grade field. If both differentiation and nuclear grade are specified, differentiation takes priority. N/A N/A 2010
    		20150038

    Reportability/MP/H Rules/Histology: Is malignant perivascular epithelioid cell tumor (PEComa) reportable, and if so, what is the histology code?

    Malignant perivascular epithelioid cell tumor (PEComa) is reportable because it is malignant. Assign 8005/3 to malignant PEComa.

    We consulted an ICD-O-3 expert who explained that some PEComas such as angiomyolipoma and lymphangiomyomatosis have specific ICD-O codes and their malignant counterparts may be coded to 8860/3 and 9174/3 respectively. There are no separate ICD-O codes for other specific PEComas, e.g., clear cell “sugar” tumor of lung, clear cell myomelanocytic tumor of the falciform ligament and some “unusual” clear cell tumors occurring in other organs—or for PEComa, NOS. These PEComas may therefore be coded to 8005 as clear cell tumors NOS; in other words as clear cell tumors that are not clear cell variants of carcinomas, sarcomas, or other specific tumor type.

    Please note, PEComa is non-specific as to behavior. Unless the pathologist states that it is malignant, (as was the case for this question), the default code is 8005/1 (non-reportable).

    		N/A Histology 2015
    		20130070

    Reportability--Is "intraductal papillary mucinous neoplasm with low grade dysplasia" (also called IPMN adenoma) reportable? See Discussion.

    According to the ICD-O-3, the histology for IPMN adenoma is 8453/0 is non-reportable. However, per SINQ 20021099, this is reportable.

    Intraductal papillary mucinous neoplasm (IPMN) of the pancreas with low grade dysplasia, also referred to as IPMN adenoma, is not reportable.

    IPMN of the pancreas is reportable when stated as "IPMN with high-grade dysplasia," or "IPMN with an associated invasive carcinoma," or  "IPMN with an associated in situ carcinoma."

    The case in SINQ 20021099 is stated to have "multifocal high grade dysplasia (so-called borderline tumor and carcinoma in-situ)" and is reportable because there is an explicit statement of carcinoma in situ, not because of the reference to the presence of high grade dysplasia. It is coded 8453/2 [Intraductal papillary-mucinous carcinoma, non-invasive].

    		 N/A N/A 2013
    		20150030

    First course treatment--Surgical rocedure of other sites: How is this field coded when the patient undergoes a lung wedge resection for a pulmonary nodule that was never definitively or was ambiguously stated to be a metastasis? See Discussion.

    The patient was diagnosed with a carcinoid tumor of the small intestine. The pre-surgical work-up also identified a lung nodule that showed no octreotide uptake, but was indeterminate on biopsy. The imaging differential diagnosis included carcinoid, hamartoma, or a non-calcified granuloma. The patient underwent a resection of the primary small bowel tumor, and the physician noted the lung nodule was of unclear diagnosis. The physician stated a solitary lung metastasis would be atypical, but that lung metastatic involvement could not be ruled out. The physician recommended resection of the lung nodule to ensure that the patient was disease free. The lung wedge resection proved a pulmonary hamartoma.

    The rules for coding Surgical Procedure of Other Site are not entirely clear. The definitions for First Course of Therapy in the SEER Manual do state that treatment includes, "Procedures that destroy or modify primary (primary site) or secondary (metastatic) cancer tissue." This would seem to exclude the lung resection as it did not destroy, modify or remove metastatic cancer tissue. However, the instructions for coding Surgical Procedure of Other Site do not address removal of distant sites that are not incidental. The lung resection was not incidental; the physician recommended it to ensure the lung was not involved, but it also disproved metastatic involvement. Should the Surgical Procedure of Other Site field be coded 0 (none) or 4 (non-primary surgical procedure to distant site) in this case?

     

    Code 0 for Surgical Procedure of Other Site in this case. The Surgical Procedure of Other Site field is used to capture surgery to destroy or modify cancer tissue that is not captured in other surgery fields.

    		N/A First course treatment 2015