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Report Produced: 02/23/2026 17:11 PM

Report Question ID Question Discussion Answer Year
20091072 Histology--Brain and CNS: How is histology coded for a "rosette-forming glioneuronal tumor" of the fourth ventricle?

Assign histology code 9505/1 [Ganglioglioma, NOS].

Rosette-forming glioneuronal tumor of the 4th ventricle is a new WHO entity. There is no current ICD-O-3 code for this. The best code available at this time is 9505/1.

 2009
20091126 MP/H Rules/Multiple primaries--Vagina: How many primaries should be abstracted for a patient with a complex history of multiple occurrences of vaginal intraepithelial neoplasia (VAIN III) between 2001 and 2008 and invasive squamous cell carcinoma (SCCA) of the vagina diagnosed in 2006 and again in 2008? See Discussion. Patient had VAIN III in March of 2001. She had a partial vaginectomy and then continues to have laser surgery in 2002, 2003, 2005 and 2006 for recurrences. In 12/2006 she is diagnosed with SCCA of the vagina with microinvasion (new primary). Then in 2/2008 she has VAIN III again -- new primary according to rule M10 (more than 1 year later). An invasive SCCA of the vagina is again diagnosed in 9/2008. Is this another new primary per rule M15 (invasive after in situ)? Every instance in 2008 is called a recurrence, but we disregard that statement.

There are two primaries according to the information provided.

1. VAIN III March 2001.

2. SCCA of vagina Dec. 2006 (invasive tumor following an in situ

For cases diagnosed 2007 or later, the MP/H rules apply to new tumors, which means that there has been a disease-free interval at some point. In this case, the patient has never been declared disease-free (NED) using the information provided in the question. The consistent recurrence of VAIN is typical of this disease.

 2009
20091087 Reportability--Appendix: Is a metastatic low-grade appendiceal mucinous neoplasm reportable if the pathologist states that it is a borderline tumor of the appendix? See Discussion. Low-grade appendiceal mucinous neoplasm; Lt ovary, cul-de-sac, omentum, and small bowel: Metastatic low-grade appendiceal mucinous neoplasm. Per pathologist this is a borderline tumor of the appendix. Borderline tumors (other than brain and CNS) are not reportable to SEER. In the case of borderline tumors, the term "metastatic" does not automatically make them reportable. When the "metastatic deposits" are also borderline, the case is not reportable. For this case in particular, the "metastases" are actually (benign) implants and not malignant or invasive mets. 2009
20091008 Surgery of Primary Site--Breast: How is this field coded when a mastectomy and a sentinel lymph node excision, that yields only one lymph node, are performed? See Discussion. Is there a minimum number of lymph nodes that must be removed in order to code a modified radical mastectomy? Assign code 41 [Total (simple) mastectomy...] for a simple mastectomy with removal of one or more sentinel lymph nodes. As long as the nodes removed are designated sentinel, use code 41 for a simple mastectomy. 2009
20091088 MP/H Rules/Histology--Breast: How is histology coded for a diagnosis of "metaplastic carcinoma with the sarcomatous component of high grade sarcoma with focal areas of osteoid formation"? See Discussion. Right breast simple mastectomy, path: 2.5 x 1.5 x 1.5 cm metaplastic carcinoma with; the sarcomatous component is high grade sarcoma with focal areas of osteoid formation. The epithelial component is predominantly grade 2 DCIS. For cases diagnosed 2007 or later, assign code 8575 [Metaplastic carcinoma, NOS]. Metaplastic carcinomas often include mixtures of epithelial carcinoma with sarcoma, for example. 2009
20091115 MP/H Rules/Multiple primaries - - Melanoma: How many primaries are reported when a patient presents with a malignant melanoma (NOS) and a separate lentigo maligna, both on right chest? See Discussion.

MP/H rule M5 states that melanomas with ICD-O-3 histology codes that are different at the third number are multiple primaries. However, the 2007 MP/H fundamentals Webcast session on melanoma rules states that this is not two histologic types. Lentigo maligna is a growth pattern, not a histologic type. Will clarification be included in the next MP/H rules revision?

For cases diagnosed 2007 or later, two primaries are to be reported for this case. Rule M5 applies because there is a difference in the histology codes at the third digit.

Clarifications regarding histologic types of melanoma will be added to the rules when they are revised.

2009
20091006

Primary site--Lung: What primary site code is used for bronchus intermedius?

Assign code C340 [main bronchus].

The bronchus intermedius is the lower part of the main bronchus on the right side. The bronchus intermedius begins just below the point where the upper lobe bronchus branches off from the main bronchus. The bronchus intermedius branches into the middle lobe bronchus and the lower lobe bronchus.

2009
20091035 CS Extension--Ovary: What code is used to capture omental caking?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.The term "omental caking" refers to a thickened omentum. In the case of ovarian cancer, omental caking is always indicative of involvement of the omentum. The omentum is an abdominal structure for the purposes of CS extension. Assign the appropriate code between 70-73.

When the size of implants is not stated, but operative report and scans state omental caking, code 71 would be best. When there are no size measurements on the operative report or scan or elsewhere, there is not enough information to assign 72. The choice of code between 70 and 73 will depend on the details of the specific case.

 2009
20091123

Reportability: Is a tumor reportable if the pathology report indicates a non-reportable diagnosis at the time the specimen is removed but subsequent clinical statements state the patient had a reportable tumor? See Discussion.

The 2007 SEER Manual (page 3) states that cases diagnosed clinically are reportable. Exception 2 states if enough time has passed that it is reasonable to assume the physician has seen the negative pathology report, but the clinician continues to call this a reportable disease, accession the case.

SEER reporting guidelines state that severe dysplasia is not reportable, however, many clinicians regard it to be equivalent to carcinoma in situ.

Example 1: In 09-2007 the pathology report for excisional biopsy of right floor of mouth states the final diagnosis is severe dysplasia. At the time, the case is not accessioned based on non-reportable pathology. Patient is subsequently admitted in 3-09. According to the clinical history the patient was diagnosed with squamous cell carcinoma in 2007 and treated with laser. Is this reportable? If yes, how is behavior to be coded? How is "Ambiguous Terminology at Diagnosis" to be coded?

Example 2: In 2-08, the pathology report for a punch biopsy of a skin lesion states the final diagnosis is atypical melanocytic hyperplasia. In 3-08, patient is admitted for re-excision. The clinical diagnosis states re-excision being done for melanoma in situ.

Reference: SINQ 20061123

A tumor that is non-reportable based on the pathology report diagnosis should not be accessioned if later clinician statements mistakenly refer to it as a reportable tumor. The exception in the 2007 SEER manual on page 3 is intended to allow the registrar to accession a case when the clinician actually disagrees with the pathology report and clinically diagnoses a reportable tumor.

 2009
20091003 MP/H Rules/Histology--Peritoneal primary: Can the cell types from the primary site and a metastatic site be combined to code histology? See Discussion. Patient has vaginal mass biopsy diagnosed as 'papillary carcinoma with psammoma bodies.' Two weeks later the patient has laparoscopy with multiple peritoneal biopsies, diagnosed as 'well differentiated serous adenocarcinoma'. Patient stated to have peritoneal primary with mets to vagina and was treated with chemotherapy. Do we code the histology to 8441/31 from the primary site biopsies, or can we use 8460/3, combining the cell types from the primary and metastatic sites? Please see SINQ 20041062 for a similar question before the 2007 MP/H rules.

For cases diagnosed 2007 or later, assign code 8441 [serous adenocarcinoma, NOS].

Code the histology from the primary site when available. Do not combine histologies from primary and metastatic sites.

In this primary peritoneal case, the diagnosis from the peritoneal biopsies was serous adenocarcinoma.

 2009