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Report Produced: 10/08/2026 00:43 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20031006 EOD/Surgery of Primary Site--Melanoma: If a melanoma primary site is other than skin, vulva, penis, or scrotum should these fields be coded using melanoma schemes? See discussion. Should a melanoma of the cervix be coded using the melanoma or the cervix schemes for these fields? For cases diagnosed 1998-2003: Use the EOD and surgery code schemes for cervix uteri. The EOD scheme for melanoma excludes melanoma of the cervix uteri. The surgery code scheme for skin excludes cervix uteri. Melanoma Surgery of Primary Site 2003
20000418 Measured Thickness/EOD-Extension--Melanoma: If the Clark's level is not provided, can it be estimated using the depth of invasion provided in the pathology report and associating that number with the Clark's levels identified in the SEER Summary Staging Guide?

For cases diagnosed 1998-2003:

No. Do not use the SEER Summary Stage Guide or any other guide to derive an estimated Clark's level from the thickness identified in the pathology report. The two measurements need to come directly from the pathology report. Each is coded separately in EOD. Thickness is collected in a separate field so we can capture the actual measurement stated in the pathology report. This has made it possible for us to group depth of invasion for analysis purposes in any manner we might wish. In addition, we can always collapse this information to the Summary Stage or TNM using the AJCC rules. AJCC rules use both depth of invasion and thickness in determining pathologic staging, and, if there is an inconsistency between them, the rules say code to the higher T classification, that is, the least favorable finding.

 Melanoma N/A 2000
20051078 Surgery of Primary Site--Melanoma: If the surgical margins are greater than 1 cm for length and width but less than 1 cm for depth, do we code surgery in the 30-33 range? Yes, assign a surgery code from the 30-33 range when any margin is less than 1 cm. Since tumor thickness is an important prognostic factor for cutaneous melanoma, the deep margin is of particular importance. Melanoma Surgery of Primary Site 2005
20110040

Reportability--Melanoma: Is a pathology report with a final diagnosis stating only non-reportable terms, followed by a re-excision pathology report that indicates "no residual melanoma" reportable? See Discussion.

Is a case reportable if the final diagnosis on an initial pathology report states a non-reportable term (e.g., evolving melanoma, early/evolving melanoma or melanocytic nevus) and followed by a subsequent re-excision pathology report stating there is "No residual melanoma"? There is no mention in the clinical history on the subsequent pathology report that the diagnosis was thought to be melanoma following the first procedure. The first mention of the reportable term was in the final diagnosis of the subsequent pathology report that stated "no residual melanoma."

No. This case is not reportable based on the information provided. "No residual melanoma" is not diagnostic of a reportable neoplasm.

We recommend that you try to obtain more information from the clinician/pathologist for this case due to the poor documentation. Check for any additional resection performed.

 Melanoma N/A 2011
20170027

MP/H Rules/Multiple primaries--Melanoma: Is a melanoma with an unknown laterality a different laterality for the purposes of applying Multiple Primaries/Histology Rule M4? See Discussion.

8/1/2016 Left Abdomen biopsy: Early melanoma in situ (C445-2, 8720/2).

9/2/2016 Upper back: Superficially invasive malignant melanoma (C445-9, 8720/3).

Does rule M4 apply and multiple primaries should be reported or does rule M8 apply and a single primary should be reported?

Abstract multiple primaries following Multiple Primary Rule M4. Unknown laterality is a different laterality for the purposes of applying the MP/H rules for melanoma.

NOTE: This answer applies to cases diagnosed prior to 2018. As of 1/1/2018, early melanoma is not reportable.

 Melanoma N/A 2017
20081055 MP/H Rules--Melanoma: How many primaries are represented if subsequent to a diagnosis of malignant melanoma of skin of left thorax in April 2006, a metastatic melanoma is discovered in the soft tissue of the abdomen and in the skin and subcutaneous tissue of the groin in late 2007? See Discussion.

4/20/06: skin left lateral thorax, excision: Pedunculated malignant melanoma, 0.5 CM in height, Clark's level 3, Breslow depth 0.5 CM, superficial ulceration noted. No host response. Margins clear.

6/19/06: Four sentinel LNs negative. Interferon therapy.

10/30/07: FNA of soft tissue, left lower abdomen: consistent with metastatic melanoma.

12/20/07 A) sentinel lymph node, left groin, biopsy: No morphologic or immunophenotypic findings support for metastatic melanoma (see comment). B) skin and subcutaneous tissue, left groin, excisional biopsy: Metastatic malignant melanoma (see comment). Lymphovascular invasion identified. Margins free of melanoma. Melanoma 1.5 MM from the closest designated deep margin and 5 MM from the designated 6:00 margin. C) skin, left groin/additional inferior margin, excisional biopsy: No significant histopathologic abnormality. No evidence of villus or melanoma or malignancy. Comment: A 0.8 cm metastatic nodular melanoma is present in the adipose tissue. The underlying skin is unremarkable. There is no evidence of ulceration, melanocytic lesion, melanoma in situ, or regression of melanoma. Block A1 is sent for immunohistochemical studies. The immunophenotypic findings provide no support for metastatic melanoma in lymph node. Please see the immunohistochemical study. The primary MD states "Recurrent intransit mets, left groin."

 For cases diagnosed 2007 or later, this is a single primary, melanoma of the thorax 4/20/06. The subsequent reports mention metastases, but do not document another primary. Do not count metastatic lesions as new primaries. Melanoma N/A 2008
20120030

MP/H Rules/Histology- -Melanoma: What is the correct histology code if the final diagnosis for an excisional biopsy specimen is reported as "malignant melanoma, superficial spreading type" but the under the "cell type" section in the CAP protocol layout of the pathology report it lists "cell type: epithelioid"? See Discussion.

The MP/H rules do not address the concept of "cell type" for melanomas when the pathologist uses the CAP protocol to report findings and the cell type listed in that section of the report differs from the specific cell type mentioned in the final diagnosis. Does a case have two specific cell types when the final diagnosis and the "cell type" sections of a single pathology report indicate two more specific melanoma histologies?

Pre-2007 SINQ entries indicate the cell type should be coded. However, if it differs from the specific cell type listed in the final diagnosis does it matter? Do the MP/H rules still take the cell type into account?

Code the histology to malignant melanoma, superficial spreading type [8743/3] based on the final diagnosis. For cases diagnosed 2007 or later, the steps used to arrive at this decision are:

Open the Multiple Primary and Histology Coding Rules manual. For a melanoma primary, use the Melanoma Histology rules to determine the histology code because there are site specific rules for cutaneous melanomas.

Start at Rule H1. The rules are intended to be reviewed in consecutive order from Rule H1 to Rule H10. The rules are intended to be reviewed in consecutive order within the applicable Module. Code the more specific histologic term when the diagnosis is melanoma, NOS [8720] with a single specific type (i.e., superficial spreading) mentioned in the final diagnosis.

The final diagnosis takes precedence over the CAP protocol. The CAP protocol may be used when it provides additional or noncontradictory information, but that does not apply in this case.

 Melanoma Histology 2012
20170018

MPH Rules/Multiple primaries--Melanoma: Does MP/H Rule M7 (diagnosed more than 60 days apart) apply to invasive melanoma cases with margins positive for in situ melanoma, or are these further excision of the original diagnosis and the same primary, even when it appears treatment was complete after the initial excision? See Discussion.

A dementia patient has been managed for a persistent right cheek skin lesion that has been slow growing for about 5 years. It was biopsied in 12/23/15 revealing a Breslow 0.12 mm lentigo maligna melanoma by an outside provider. A larger resection of the lesion on 2/3/16 demonstrated a Breslow 0.30 mm lentigo maligna melanoma with melanoma in situ present at the margins per the available pathology report. There was no statement in the record that any additional treatment was planned or necessary.

Patient healed well from the 2/3/16 procedure but developed a recurrent lesion in May that was biopsied on 5/10/16 by the same outside provider which again reveal lentigo maligna melanoma. 7/5/16 Reexcision at the current facility revealed a Breslow 6.1 mm lentigo maligna melanoma, Clarks level V. This was a cutaneous tumor per the path report and not a subcutaneous nodule. Clinically, the MD called this a , but there was no slide comparison to the previous melanoma.

In auditing files for expected (but not received) abstracts due from facilities, we've observed these types of cases not being consistently reported as multiple primaries.

Rule M7 pertains to separate tumors. Rule M7 does not apply to invasive melanoma cases with margins positive for in situ melanoma.

Based on the information provided, it is not clear whether or not the 5/10/16 diagnosis is a separate lesion or the same lesion that was diagnosed earlier.

 Melanoma N/A 2017
20091014

MP/H Rules/Histology--Melanoma: Please clarify what we should code when we see the term 'spitz or spitzoid' in association with melanomas. See Discussion.

Path reports often diagnose "melanoma with spitzoid features." There is no code for this in ICD-O-3. Would it be melanoma NOS with a specific type for MP/H rule H9 (with features of...), or would we stop at H3? Could the matrix principle apply, changing 8770/0 (one of the synonyms is Spitz nevus) to 8770/3 (although no Spitz synonyms are specifically listed under this code)? What if the path report says "melanoma arising in a Spitz nevus"?

For cases diagnosed 2007 - 2020

Assign code 8720/3 [Malignant melanoma] for melanoma with Spitzoid features, Spitzoid variant of nevoid melanoma, melanoma arising in Spitz nevus, or Spitzoid melanoma. The WHO Classification of Tumors groups these with Nevoid melanomas and codes them to 8720/3.

According to WHO, "Nevoid melanoma is a subtype of malignant melanoma of the skin that is distinctive in that the primary lesion mimics many of the architectural features of a common compound or intradermal nevus ... or a Spitz nevus... These lesions are defined not as atypical nevi, but as melanomas because they involve the dermis and have the potential for metastasis."

 Melanoma Histology 2009
20010155

Reportability/Diagnostic Confirmation--Melanoma: Would a shave biopsy diagnosis of "highly suggestive of early melanoma", followed by a re-excision diagnosis of "no residual disease", be SEER reportable if the clinician referred to the case clinically as a melanoma? If so, what would the Diagnostic Confirmation be? See discussion.

Pathology report from a shave biopsy states: "...markedly atypical junctional melanocytic proliferation. Changes highly suggestive of early melanoma arising adjacent to superficial congenital nevus." The re-excision pathology report states "biopsy proven melanoma" in the "Clinical History" section of the report (which is a reference to the original shave biopsy). The re-excision final pathology diagnosis states "no evidence of melanoma." The physician states that he thinks this is a melanoma. Should it be reported? Should Diagnostic Confirmation be coded to 1 or 8?

The case is reportable because the physician documented a clinical diagnosis of malignant melanoma. Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only (other than 5, 6 or 7)].

 Melanoma Diagnostic confirmation 2001