MP/H Rules--Lung: Why the term "nodule" is not included as an equivalent term along with tumor, mass, lesion and neoplasm in the 2007 lung multiple primary rules?
Answer revised July 2008
For cases diagnosed 2007 or later:
For the purpose of applying the Lung MP/H rules, the word "Nodule" can be used interchageably with "Tumor," "Mass," "Lesion" and "Neoplasm." HOWEVER, this does NOT apply to casefinding or staging.
This revision will be added to the next version of the MP/H rules. Sinq question 20071028 will be revised.
MP/H Rules: Regarding rules for Renal Pelvis, ureters, bladder & urethra - Please clarify Rule M8. Rule M8 references Table 1, but table 1 is a table of histologies not primary sites, Rule M8 also seems to contradict Table 2 and Rule M10. Does it matter where the first primary is, ie bladder then urethra or bladder then renal pelvis?
Table 2 does not apply to diagnoses in 2007 and later. A watermark over (or near) Table 2 states "Do not use for cases diagnosed on or after 2007." Table 2 lists previous SEER site groupings for cases prior to 2007.
The MP/H rules are in hierarchical order. Use the first rule that applies. When Rule M8 applies, there is no need to check Rule M10. Rule M8 is for the urinary sites listed and derives single primary. Rule M10 is for all sites, except the sites listed in Rule M8, and derives multiple primaries.
It does not matter where the first primary is, i.e. bladder then urethra or bladder then renal pelvis. If there are two or more tumors in two or more of these four sites listed in Rule M8 with histologies listed on Table 1, abstract as a single primary.
Reportability--Brain and CNS: Are hemangioma, NOS (9120/0), cavernous hemangioma (9121/0) or venous hemangioma (9122/0) reportable when they arise in the brain or CNS?
Hemangioma, NOS (9120/0) and cavernous hemangioma (9121/0) arising in the dura and parenchyma of the brain/CNS are reportable.
Venous angiomas (9122/0) are not reportable wherever they arise. The primary site for venous hemangioma arising in the brain is blood vessel (C490). The combination of 9122/0 and C490 is not reportable. This is a venous abnormality. Previously called venous angiomas, these are currently referred to as a developmental venous anomalies (DVA).
Reportability/Histology: Is this reporatable? If so, what is the correct histology?
2012 duodenal nodule biopsy, pathology positive for well differentiated neuroendocrine neoplasm.
Report this case as 8240/3. In this context, well differentiated neuroendocrine neoplasm seems to be a synonym for neuroendocrine tumor (NET) G1 (carcinoid). According to the WHO classification, "Neuroendocrine neoplasms of the duodenum comprise NETs..."
MP/H/Multiple primaries--Urinary: In Aug 2008 Patient was diagnosed with Noninvasive Bladder Cancer. In Oct 2013 Patient was diagnosed with Transitional Cell Carcinoma of Right Ureter involving lamina propria, Noninvasive Transitional Cell Carcinoma Left Ureter and Invasive Transitional Cell Carcinoma of Prostatic Urethra. Is this a new primary and what is the primary site?
Rule M7 applies when comparing the 2008 diagnosis to the 2013 diagnosis: multiple primaries.
Rule M8 applies to the tumors identified in 2013: single primary.
Based on the information provided, code the primary site for 2013 to C689 because there is no indication of the site of origin among the involved sites.
Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted when bilateral breasts are involved with MALT lymphoma and the bone marrow is negative?
Per Rule M2, this is a single primary because there is a single histology mentioned. The histology is coded to 9699/3 [MALT lymphoma]. Code the primary site to C509 [breast] per Rule PH24 which states to code the primary site to the organ when lymphoma is present only in an organ.
Unless your software has edits that prevent coding laterality for lymphomas, code the laterality as bilateral. Up to half of extranodal, extragastric MALT lymphomas occur in multiple sites, particularly in paired sites (breast is an example).
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.
MP/H Rules/Histology--Skin: How is the histology coded for a "malignant baso-melanocytic tumor" arising in the skin of right shoulder?
Code the histology as melanoma, NOS [8720/3].
This is a malignant skin tumor with both melanoma and basal cell carcinoma histologies. There is no ICD-O-3 code for this entity. Per our subject matter expert, code the histology to 8720/3 [melanoma, NOS] and document the diagnosis of malignant baso-melanocytic tumor in a text field because melanoma is reportable to SEER and basal cell carcinoma is not.
MP/H Rules/Multiple primaries--Breast: How many primaries are reported and what is the histology for each in a case of infiltrating duct and lobular carcinoma of the breast (8522) with Paget disease of the same breast?
Abstract as two primaries according to rule M12. We interpret this as one tumor with infiltrating duct and lobular carcinoma (8522) and a second tumor with Paget disease (8540).
MP/H Rules/Multiple primaries--Breast: Does breast Rule M10, 'Tumors that are lobular (8520) and intraductal or duct are a single primary" apply if you have two tumors in the same breast, one ductal and the other tubulolobular (8524) or are they separate primaries per Rule M12?
Apply Rule M10 to this case. Tubulolobular is now classified as a variant of lobular. Code to lobular, NOS (8520) because Tubulolobular does not have a specific ICD-O-3 code.
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