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Report Produced: 05/26/2026 04:23 AM

Report Question ID Question Discussion Answer Year
20140002 Reportability--Appendix: Is a pathologic final diagnosis of an appendix with "well-differentiated neuroendocrine tumor (carcinoid)" reportable? See discussion. SINQ 20130027 states that "well-differentiated neuroendocrine tumor" of the appendix is reportable (8240/3) while "carcinoid" tumors of the appendix are not reportable (8240/1). Please explain the difference between "well-differentiated neuroendocrine tumor" of the appendix and a "carcinoid" of the appendix.

Well-differentiated neuroendocrine tumor of the appendix is reportable. The difference is terminology. "Carcinoid" is listed in ICD-O-3 as a /1 for appendix making it non-reportable.

When both terms are used, ask for clarification from the pathologist. Failing that, accept the reportable terminology and report the case.

 2014
20140065

Summary Stage 2000--Melanoma: How should Summary Stage 2000 be coded for 2014+ diagnosed melanoma cases with satellite nodules or in transit metastases? See discussion.

The SEER SS (SSS) 2000 Manual indicates satellite nodules (NOS or less than/equal to 2cm from primary tumor) are regional by direct extension (code 2) and in-transit metastasis (satellite nodules greater than 2 cm from primary tumor) are coded as involvement of regional lymph nodes (code 3). However, CSv0205 indicates mapping for satellite nodules/in transit metastasis (coded in CS LN) was changed to Regional, NOS (code 5). There are no definitions listed for code 5 in the SSS 2000 Manual.

Our staff independently code SSS 2000. Should we code the existence of satellite nodules and in transit metastases according to the current definitions in the SSS 2000 Manual or using the mapping information from CSv0205?

Code the existence of satellite nodules and in transit metastases according to the current definitions in the SSS 2000 Manual. Do not use the mapping information from CS to code SSS.

2014
20140034

Reportability--Ovary: Can you clarify when widely metastatic borderline histologies of the ovary and various other sites are reportable? See discussion.

SINQ 20130176 states that an adult granulosa cell tumor of the ovary with metastases is malignant. However, SINQ 20091087 states that a borderline tumor of the appendix with metastasis is not reportable.

The first statement of 20130176 “though granulosa cell tumor is coded 8620/1, the presence of peritoneal or lymph node metastases indicate the tumor is malignant and coded as /3” does not coincide with the second statement of “the behavior of borderline/LMP ovarian epithelial tumors is determined by the ovarian primary, even though there may be peritoneal implants or metastatic disease in the lymph nodes”. If the ovarian metastases do make this a reportable malignancy, can this line of thinking be used to determine reportability for borderline histologies for other sites such as the appendix?

The case in 20130176 is adult granulosa cell tumor. The answer points out an important difference in the way "metastases" from this histology should be interpreted versus low malignant potential ovarian epithelial tumors. Metastases from adult granulosa cell tumor of the ovary indicates a malignant primary. So-called metastases from a LMP epithelial tumor do not indicate a malignant primary when the metastatic deposits are also LMP/borderline in behavior.

Do not apply instructions for ovarian cases to other primary sites including appendix.

2014
20140031

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.

2014
20140026

Histology: Are all well differentiated neuroendocrine carcinomas (carcinoid) tumors coded to 8240 or 8246? When do you use code 8246?

Code 8246 is correct when the mass/lesion is referred to as neuroendocrine "carcinoma" or NEC. Use code 8240 when the mass/lesion is referred to as a neuroendocrine "tumor" or NET G1. The difference is the word tumor versus carcinoma. Carcinoid is most often used interchangeably with neuroendocrine tumor and not with neuroendocrine carcinoma.

2014
20140068

Surgery of Primary Site--Corpus uteri: What is the correct surgery code to assign for dilation and curettage (D&C) for an in-situ endometrium (C541) primary? The code to use for the cervix uteri (C530-C539) is specified, but not for the corpus uteri (C540-C549).

Assign code 20 for endometrial D&C for in situ cancer of endometrium.

2014
20140078

Surgery of Primary Site--Bladder: Is any mention of cautery in the gross description of pathology for a TURBT specimen sufficient to code 22 (excisional biopsy with electrocautery), or does there need to be a statement in the operative report that electrocautery was performed? See discussion.

Often, pathology for TURBT with non-invasive papillary TCC includes a gross description with a variety of cautery descriptions. For example, "received are three cautery roughened gray-pale pink tissue fragments.” However, the operative report is documented as a "TURBT" with no further description of the procedure.

Assign code 22 when cautery is mentioned n the gross description of pathology for a TURBT specimen.

2014
20140074

Surgery of Primary Site--Brain and CNS: What procedure code would be used for NeuroBlate Laser Interstitial Thermal Therapy? This procedure was used for a Glioblastoma of the brain.

If a pathologic specimen is not taken during this procedure, code in the surgery field using code 10 (Local tumor destruction, NOS). If specimen is sent to pathology, code 90, surgery, NOS. We will request this procedure be included in future treatment field coding documentation.

Our research notes that this procedure, also known as LITT (Laser Interstitial Thermal Therapy), is a surgical treatment. Lasers transmit heat to coagulate or destroy the brain tumors from the inside out.

2014
20140071

Reportability--Lung: One of our facilities has a case they are not really sure how to report.

This patient came in for a double lung transplant due to COPD which occurred on 1/27/14. At time of transplant, the team found out the donor hospital had identified a small nodule in the right lower lobe donor lung, which they biopsied and deemed negative. However, the slides were reviewed and felt to represent adenocarcinoma. The team performed a right lower lobe lobectomy of the donor lung before transplanting into the patient.

So, we are not really sure how to handle this case. The adenocarcinoma actually belongs to the donor patient from another hospital, however, they actually didn’t identify it at that facility as their pathology was negative for a malignancy.

This very interesting case is not reportable to either facility. Since the right lower lobe nodule was resected prior to transplantation, the case does not belong to your patient. Ideally, the cancer should be assigned to the donor; however, donor information is confidential.

2014
20140022

MP/H Rules/Kidney, renal pelvis--How many primaries are there for this case? Should we stop at rule M8 making this all one primary (C689) even though there were right and left renal pelvis tumors? Rule M3, which contains laterality, does not apply because there is also a bladder tumor. See discussion.

Kidney: originally diagnosed 12/21/2011 with right renal pelvis high grade papillary urothelial cancer. Status post right nephrectomy. Then on 01/10/2013 diagnosed with low grade papillary urothelial cancer of the bladder. 01/21/2013 diagnosed with left renal pelvis urothelial carcinoma iIn situ. Path report stated this may represent a hgh grade papillary urothelial cancer – unable to confirm due to specimen size. On 01/24/2013 left periaortic lymph node biopsy revealed poorly differentiated carcinoma consistent with prior diagnosed right renal pelvis high grade urothelial cancer. Neither the bladder nor the left renal pelvis tumor was compared to the previous right renal pelvis tumor. Also has bone mets.

Abstract this case as a single primary.

First, apply the MP/H rules to compare the 2013 bladder tumor to the 2011 renal pelvis tumor. Rule M8 applies, this is a single primary. Next, apply the MP/H rules to compare the 2013 in situ renal pelvis tumor to the 2011 renal pelvis tumor. Rule M8 applies, this is a single primary. As you correctly pointed out, Rule M3 for bilateral renal pelvis tumors, does not apply because there is also a bladder tumor in this case.

2014