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Code renal cell carcinoma translocation type as renal cell carcinoma, NOS, 8312. While WHO recognizes renal cell carcinomas with associated translocations, there is no specific ICD-O-3 code for this variant of renal cell carcinoma.

Apply the Multiple Primaries/Histology, Breast Rule H3: DCIS and a more specific in situ are coded to the more specific histology term which in this case is solid. Code the histology to ductal carcinoma in situ, solid type (8230/2). Based on the information provided, there is no invasive component. The term "microca ++" means micro-calcifications are present, not micro carcinoma.

Rule H8 applies, code the histology with the numerically higher ICD-O-3 code which is papillary transitional cell carcinoma, 8130.

Based on the information provided, there is a single bladder tumor, papillary urothelial carcinoma with squamous cell differentiation. Urinary sites rule H12 does not apply because this is a single tumor, not multiple tumors. In the single tumor H rules, H3 does not apply as this rule does not include papillary transitional cell carcinoma. Rule H4 is papillary carcinoma or papillary transitional cell carcinoma and refers you to Table 1. Table 1 does not list papillary urothelial carcinoma with squamous cell differentiation because there is no ICD-O-3 code for this histology. Table 1 does list transitional cell carcinoma with squamous differentiation as code 8120, however, the papillary transitional cell carcinoma is the higher code, 8130. We will review this situation for the next version of the rules.

For cases diagnosed 2007 or later, assign histology code 8022 [pleomorphic carcinoma] based on the pathologist's assessment and rule H3. He/she reviewed all of the histologic components and rendered a final diagnosis of pleomorphic carcinoma.

"Components" is not a term indicative of a more specific histology. See note under rule H5.

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.

For cases diagnosed 2007 or later:

In the very unlikely event of a FAP diagnosis with no malignancy, the case would not be reportable.

When FAP is diagnosed along with a colon malignancy, it is presumed that the malignancy originated in one of the numerous polyps, even if this is not explicitly stated. Use rule M3 for any colon malignancy (in a polyp, frank, or not stated) with a diagnosis of FAP and abstract as a single primary.

For cases diagnosed 2007 or later, use the 2007 MP/H rules to determine whether or not a subsequent diagnosis (either invasive or in situ) is a new primary or a recurrence. Do not use the statement "recurrence" from the medical record to make this decision.

When evaluating a subsequent diagnosis and the MP/H rules indicate "single primary," the tumor being evaluated is a "recurrence" of the original primary cancer.

Accession a single primary, the original ovarian serous carcinoma. The MP/H Rules do not apply to metastases.

Metastases: When cancer cells appear in other nodes or organs that are not the primary site they are metastatic cells. Discontinuous (separate from the primary tumor) masses or cells in regional lymph nodes, distant lymph nodes, or distant sites are always metastases. In this case, the sacral and pelvic masses are distant metastases. The pathologist does not have to compare cells to the original tumor slides; the discontinuous tumor mass/cells in any site other than the primary site are metastases.

Recurrence: For a disease to recur there are several criteria that must be met. First and most important, the patient must have had a disease-free interval (a tumor cannot recur if it has always been present). The other criteria are: the "new tumor" has to occur in the original primary site, it must be the same histology as the original tumor, AND must meet the timing requirements in the MPH rules for that organ/site.

For cases diagnosed 2007 or later, abstract the 2007 diagnosis as a separate primary using rule M5.

Rule M5 applies to this case because it comes before rule M12. Furthermore, based on your statement, the answer presumes that the original tumor was duct carcinoma only, there was no lobular carcinoma present. This must be a new primary because there are two different histologies.

The 2007 MP/H rules were developed with input from clinicians. They advised that a subsequent breast tumor more than five years later is a new primary. It is important to apply the rules so that these cases are handled in a consistant manner across all registries.

For cases diagnosed 2007 or later, Rule M8 applies. This is a single primary. The primary site was coded to C659 in 2008. Do not change the primary site code.