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Report Produced: 10/07/2026 21:07 PM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20130009 Grade--Pancreas: Can the grade be coded when a biopsy is taken from the part of a primary tumor that has contiguously extended into an adjacent organ or structure? See Discussion. The grade rule states to code grade from tissue removed from the primary tumor only, never from a metastatic site or a site of recurrence. There is no mention of whether the grade can be coded if only the contiguous site of involvement is biopsied when a single tumor directly extends to an adjacent tissue or organ. For example, is grade coded to 2 when a pancreatic tumor extends into the duodenum, and the duodenal biopsy confirms moderately differentiated adenocarcinoma consistent with a pancreatic primary? Or does the primary organ/site have to be biopsied in order to be able to code grade?

For one tumor involving a contiguous site, when there is no tissue specimen available from the primary site, you may code the grade based on the tissue from the tumor in the contiguous site.

This instruction is included in the upcoming grade instruction document.

 Pancreas N/A 2013
20021052

EOD-Extension--Pancreas: Should these terms be ignored when coding extension to 10 or 30, or do they indicate involvement for non-surgically treated pancreas primaries?

1) Stricture of the common bile duct

2) Common bile duct is narrowed

3) Common bile duct is obstructed

4) Common bile duct dilation

5) Malignant stricture of the common bile duct

6) Ampullary or common bile duct stricture with a negative biopsy or brush.

For cases diagnosed 1998-2003:

Ignore these terms when coding extension to 10 or 30. These terms do not verify involvement by pancreatic cancer of the organs mentioned. Other non-malignant circumstances could cause these conditions.

 Pancreas N/A 2002
20071086 Histology--Pancreas: How is a "gastrin and somatostatin producing endocrine neoplasm" coded that has lymph node metastasis?

The best code available for this situation is 8153/3 [Gastrinoma, malignant].

Many pancreatic endocrine tumors produce more than one peptide, such as gastrin and somatostatin in this case. ICD-O-3 does not provide a code for pancreatic endocrine tumors which produce more than one peptide. According to the WHO Classification of Tumours of Endocrine Organs, there is a distinct hormonal syndrome associated with gastrin producing tumors, and not with many of the somatostatin producing tumors. Therefore, our pathologist consultant advises us to code to gastrinoma in this case.

 Pancreas Histology 2007
20041001

Histology (Pre-2007)--Pancreas: Should pancreatic neoplasia III (PanIN III) be coded to 8010/2 [carcinoma in situ, NOS] or 8500/2 [Ductal carcinoma in situ]? See Description.

There is no specific morphology code for PanIN-III in the ICD-O-3. In the chapter for exocrine pancreas found in the sixth edition of AJCC cancer staging manual, pg 160, reference is made to PanIN-III and its inclusion with carcinoma in situ.

For tumors diagnosed prior to 2007:

Code PanIN-III (pancreatic intraepithelial neoplasia III) as 8500/2 [Ductal carcinoma in situ, includes DIN 3: Ductal intraepithelial neoplasia 3]. PanIN-III is a synonym for carcinoma in situ according to the WHO classification of Tumors and the College of American Pathologists' Protocol for exocrine pancreas. Do not code PanIN-I or PanIN-II as cancer.

For tumors diagnosed 2007 or later, see SINQ 20110081 and refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

Pancreas Histology 2004
20170063

Reportability/Behavior--Ovary: Is adult granulosa cell tumor a reportable malignant tumor if the primary ovarian tumor ruptured intraoperatively, the peritoneum was contaminated, and the patient underwent adjuvant treatment with chemotherapy given the increased risk of recurrence due to intraoperative tumor spill? See Discussion.

Per SINQ 20130176 and 20140034, adult granulosa cell tumors of the ovary are reportable malignant tumors when there are peritoneal implants or metastases. The SINQ responses describe how these adult granulosa cell tumors are different from low malignant potential (LMP) epithelial ovarian tumors. Would these SINQ scenarios apply to a case with intraoperative tumor rupture that resulted in peritoneal tumor?

In this case, the pathologist indicated these excised peritoneal specimens were favored to be intraoperative contamination with adult granulosa cell tumor. However, the oncologist went on to treat this patient as high risk with chemotherapy. The oncologist only described one of the pelvic peritoneal implants as possibly contamination due to the rupture. The oncologist never indicated the tumors were definitely peritoneal implants. Should the behavior of this tumor be /1 because the peritoneal tumor appears to be contamination, or /3 because the oncologist treated this patient as high risk?

If the "implants" were due to intraoperative contamination and were not present prior to surgery, do not interpret them as indicative of malignancy. The behavior of this tumor is /1.

 Ovary Behavior 2017
20081077 MP/H Rules--Ovary: How do you code histology for a diagnosis of "clear cell CA, predominately cystic." For cases diagnosed 2007 or later, assign histology code 8310 [Clear cell carcinoma]. Cystic describes the appearance of the tumor. Clear cell is the histologic type. Code clear cell carcinoma 8310/3. Rule H11 applies. Ovary N/A 2008
20031103

Reportability--Ovary: Is a Stage IIIC serous borderline tumor (micropapillary type) of the ovary diagnosed in 2003 reportable?

Serous borderline tumor of the ovary diagnosed in 2003 is not reportable to SEER. The behavior code is /1 in ICD-O-3. The high stage does not make this borderline tumor reportable. Ovary N/A 2003
20051126 Histology (Pre-2007)--Ovary: What codes are used to represent "mixed papillary serous and clear cell carcinoma" and "papillary serous carcinoma with focal clear cell features" of the ovary?

For tumors diagnosed prior to 2007:

Assign code 8323 [Mixed cell adenocarcinoma] to "mixed papillary serous and clear cell carcinoma." This is histology coding rule 3 in the 2004 SEER manual under single tumor (page 86). There is no other code for this mixture.

Example 1: 8323

Example 2: 8461 (clear cell is not coded according to Rule 6, page 87, because it is not the majority of the tumor).

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

 Ovary Histology 2005
20091056 MP/H Rules/Histology--Ovary: How is histology coded for an ovarian tumor diagnosed as an "ovarian clear cell cystadenocarcinoma"? See Discussion. Final diagnosis for a resected ovary is ovarian clear cell cystadenocarcinoma. In applying the MP/H rules, rule H16 does not apply because cystadenocarcinoma is not included in Table 2. As a result rule H17 applies. Thus it appears the histology should be coded 8440. Cystadenocarcinoma is a specific histologic type and it is assigned the numerically higher histology code. This result differs from pre-2007 SINQ entry 20041045 that states: Code histology to 8310/3 [Clear cell adenocarcinoma, NOS]. This is consistent with the WHO Classification of Tumours and reflects the current practice of placing less emphasis on "cyst-" prefix for ovarian malignancies.

For cases diagnosed 2007 or later:

Assign code 8310 [Clear cell adenocarcinoma] according to rule H13. Ignore "cyst" when determining the histologic type for ovarian malignancies. For this case, the only histology is clear cell.

The histologies for the common ovarian epithelial malignancies are serous, mucinous, endometrioid, clear cell, and transitional cell/Brenner. This clarification will be added to the rules in the next revision.

Ovary Histology 2009
20071108 MP/H Rules--Ovary: Rule M7 states bilateral epithelial tumors (8000-8799) are reportable as a single primary. Are bilateral germ cell tumors of the ovary (e.g., dysgerminoma (9060/3)) that occur simultaneously now reported as two primaries? For cases diagnosed 2007 or later, rule M7 applies to ovarian epithelial tumors with ICD-O-3 histology codes between 8000 and 8799. Rule M7 does not apply to dysgerminoma which is coded to 9060. Go on to the next rule, M8 and abstract as multiple primaries, left and right. Ovary N/A 2007