Report | Question ID | Question | Discussion | Answer | Year |
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20190050 | Reportability/Melanoma: Is evolving melanoma reportable with a Clark's level and Breslow's thickness are cited in the pathology report? See Discussion. |
How do we interpret the reportability of the following: The histological and immunohistochemical findings are most consistent with an early-evolving malignant melanoma, superficial spreading type, with Clark's level II and maximal Breslow thickness 0.33 mm, arising in association with an atypical nevus. Since a Clark's level and Breslow's thickness are included, is this reportable? Is this really an evolving melanoma? |
As of 01/01/2021, early or evolving melanoma in situ, or any other early or evolving melanoma, is reportable. |
2019 |
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20150036 | Reportability/MP/H--Kidney: "Multilocular clear cell renal cell carcinoma." Would this be coded 8310? See discussion. |
Multilocular clear cell renal cell carcinoma is a specifc histologic type listed in the CAP cancer protocol for kidney, but not in the ICD-O-3 and it is not on the list of specific types of renal cell carcinomas in Table 1 of the kidney equivalent terms and definitions in the MP/H manual. There is a malignant multilocular cystic nephroma 8959 in Table 1, but I can't tell if this the same histology as what is stated in this path report. |
Apply Kidney rule H5 and code the clear cell (8310/3) which is the specific type of renal cell. Multilocular is a variant of clear cell which is a variant of renal cell carcinoma. As of yet, no new ICD-O morphology code as been proposed for this specific histology. It will be addressed in the revised rules. |
2015 |
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20150060 | Reportability/MP/H Rules: Where can I find documentation on how to accession malignant tumors in transplanted organs? See discussion. |
A patient was diagnosed with hepatocellular cancer (HCC) in 2010, and underwent a hepatectomy, and then received a donor liver. In 2014, HCC was discovered in the liver once again. This likely is a new primary, but there are no specific rules to cover this. There are many odd situations involving transplanted organs, many of which pose reportability and multiple primary problems. |
Accession the new tumor in the transplanted organ as you would any other new/second primary. As transplants have become more common especially for liver, lung, and kidney, we are seeing more of these types of cases. We are adding instructions to the revised MP/H rules on coding subsequent primaries when they occur in a transplanted organ. We are also looking at adding a data field that will identify cancers/tumors which arose in a transplanted organ. We feel this is important to track for analysis. Until the revised MP/H rules are implemented, we will look at adding general coding instructions to the SEER Program Manual for transplants. |
2015 |
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20180004 | Reportability/MP/H Rules/Multiple primaries: Is a ganglioneuroblastoma (9490/3) following a melanoma (8720/3) a new primary if the diagnosing pathologist states: "Given the clinical context and patient age, then I believe that this may represent transdifferentiation of metastatic melanoma'? If this is a new primary, what MP/H rule would apply? See Discussion. |
March 2017 lung biopsy showing metastatic melanoma. Subsequent workup shows imaging with additional metastatic involvement of multiple bone sites but no primary tumor is identified. Chemotherapy is started in May 2017. July 2017 biopsy of right lower quadrant mass has a final diagnosis of ganglioneuroblastoma and pathologist's comment states I believe that this may represent transdifferentiation of metastatic melanoma. Later, partial colectomy of transverse colon Gross Description indicates this was centered in the mesentery. |
Abstract two primaries: 1. unknown primary site and 2. peripheral nerves and autonomic nervous system of abdomen, based on Multiple Primaries/Histology for Other Sites Rule M11 (topography codes that differ at the second or third character). While it is possible in rare cases that one tumor transforms into the other, transformations do not factor into the current MP/H rules. |
2018 |
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20140035 | Reportability/MP/H Rules/Histology: Is this kidney tumor diagnosis reportable? If so, what is the correct histology? See discussion. |
Left radical nephrectomy: Tumor histologic type: Renal angiomyoadenomatous tumor (see Note). Note: The a clear cell papillary renal cell tumor and a renal angiomyoadenomatous tumor (""RAT"") (reval cell carcinoma with angioleiomyoma-like stroma). Although some authors consider RAT tumors to represent a pattern of clear cell papillary RCC we believe that this represents a dstinct entity. The combined findings ...confirm the diagnosis of renal angiomyoadenomatous (RAT) tumor. These tumors are also known as renal cell carcinoma within angioleiomyoma-like stroma. To date none of these tumors have developed metastases. Given the small number of reported cases we would consider these to have at worst a low malignant potential. |
According to our expert pathologist adviser, renal angiomyoadenomatous tumor ("RAT") is not reportable. He states "l would be reluctant to consider the entity malignant. The authors of the papers describing it do not seem ready to call it malignant either. I agree with calling it LMP, or in this case uncertain malignant potential." |
2014 |
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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). |
2015 | |
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20160037 | Reportability/MP/H Rules/Histology--Ovary: What is the histology code for an ovarian tumor described as a mucinous borderline tumor, intestinal type? |
Mucinous borderline tumor, intestinal type, of the ovary is not reportable. The behavior is /1. There is no applicable histology code for this histology when it ocurs in the ovary. |
2016 | |
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20190047 | Reportability/Liver: If on imaging, there is no statement of the Liver Imaging Reporting and Data System (LI-RADS) score but there is reference that a lesion is in the Organ Procurement and Transplantation Network (OPTN) 5 category, is hepatocellular carcinoma (HCC) reportable based on the OPTN 5 classification? See Discussion. |
SINQ 20160008 discusses the reportabilty and diagnosis date for liver primaries where imaging references the LI-RADS category as LR-5 or LR-5V. The 2018 SEER Coding and Staging Manual, Appendix E Reportable Example #16, demonstrates this concept. According to the LI-RADS categories a value of 5 is "definitely HCC" and is concordant with OPTN 5. Often we see only the OPTN categorization. |
Report HCC based on the OPTN class of 5. OPTN class 5 indicates that a nodule meets radiologic criteria for HCC. Be sure to document in text fields. |
2019 |
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20200002 | Reportability/In situ--Prostate: Has there been a change in reportability for prostatic intraepithelial neoplasia (PIN III) (C619)? The 2018 SEER Manual notes: Collection stopped effective with cases diagnosed 01/01/2001 and later; however, on the casefinding list effective 10/01/2019, code D07.5, carcinoma in situ of prostate, is listed as reportable. |
PIN III is not reportable in accordance with the 2018 SEER Manual; however, carcinoma in situ of the prostate is reportable as they represent different histology codes. The casefinding list is used to search for reportable cases and is not the same as a reportable list. |
2020 | |
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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 |