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Report Produced: 07/03/2025 02:30 AM

Report Question ID Question Discussion Answer Year
20081062 MP/H Rules/Date of Diagnosis/Behavior--Brain and CNS: How many primaries would be reported when a December 2004 MRI shows a pineal region mass with the major differential consideration being pineocytoma; a November 2007 MRI that shows the mass has almost tripled in size; and the December 2007 resection final diagnosis is consistent with pineoblastoma? How would diagnosis date[s] and behavior code[s] be coded? See Discussion.

Dec. 2004 MRI of brain: Pineal region mass. The major differential consideration given patient's gender, age group, and imaging characteristics is pineocytoma. The differential includes pineoblastoma or germ cell line tumor. These are felt less likely.

Nov. 2005 MRI brain: stable exam since last MRI. No change in size.

Nov. 2007 MRI studies: pineal mass has almost tripled in size.

Dec. 2007 Surgical resection of pineal tumor: High grade (WHO Grade IV) pineal parenchymal neoplasm consistent with pineoblastoma.

For cases diagnosed 2007 or later:

Abstract as separate primaries:

  • 12/2004 pineocytoma (9361/1)

  • 12/2007 pineoblastoma (9362/3)

    • Complete two abstracts when a previously diagnosed non-malignant tumor transforms or progresses to a malignancy. Refer to the CDC/NPCR guidelines for Data Collection of Primary Central Nervous System Tumors, 2004. Malignant transformation is discussed on page 50.

    		2008
    		20081126

    MP/H Rules--Brain and CNS: Are stigmata of neurofibromatosis in the brain reportable neurofibromatosis lesions? See Discussion.

    Reference: SINQ 20051108; SINQ 20061018 Three year old patient with history of neurofibromatosis 1. 3/05 MRI of the brain showed right optic nerve glioma. It also showed heterogeneous high t2 signal in the middle cerebellar peduncles and near the genu of the internal capsules bilaterally are stigmata of neurofibromatosis type I. 3/08 MRI showed new mass suspicious for glioma in the hypothalamus. Clinical diagnosis is benign glioma secondary to diagnosis of neurofibromatosis. How many primaries are to be accessioned for this patient? Should the matrix principle be invoked for the second glioma? Should the behavior code for the glioma be 0?

    For cases diagnosed 2007 through 2017

    Accession NF (9540/1) when there is CNS tumor -- a glioma or some other intracranial/intraspinal tumor. Stigmata of NF are reportable when the stigmata themselves are reportable tumors. For example, glioma, or another intracranial/intraspinal tumor. Do not report sitgmata that are only termed "stigmata seen on MRI," for example, without other reportable terminology.

    Do NOT accession NF (9540/1) when there is only peripheral nerve/nervous system involvement.

    Accession the neurofibromatosis itself only once per patient. Accession any initial neoplasm in the CNS separately. Abstract and code any subsequent CNS neoplasms according to the multiple primary brain rules.

    Accession three primaries for the case described above.

    1. Neurofibromatosis (C729 9540/1)
    • Optic nerve glioma (C723 9421/3)--> see below.
    • Hypothalamus glioma (C710 9380/0)

    --> Optic nerve gliomas associated with NF are pilocytic astrocytomas. Code pilocytic astrocytoma as 9421/3 in North America.

    For cases diagnosed 2018 or later

    See the 2018 Solid Tumor Rules for Non-Malignant CNS tumors.

    		 2008
    		20081069 Multiplicity Counter: Should this field be coded to 99 for cases of familial adenomatous polyposis (FAP)? See Discussion. The MP/H rules state to abstract these cases as a single primary. The Type of Multiple Tumors Reported as One Primary field is coded as a single primary with a value of 32 (FAP with carcinoma), but the Multiplicity Counter seems to be unknown. Assign code 99 [Multiple tumors present, unknown how many] for cases of FAP when the number of tumors is not stated. 2008
    		20081115 CS Extension--Brain and CNS: How is this field coded for a malignant tumor presenting as a confluent lesion over right parietal, posterior frontal and thalamic regions?

    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.

    Assign CS extension code 40 [Tumor crosses the midline; Tumor involves contralateral hemisphere; Tumor involves corpus callosum (including splenium)]

    The thalamus is located between the corpus callosum and the cerebellum and brain stem. A supratentorial tumor extending to the thalamus involves the corpus callosum (extension code 40) but has not yet reached the cerebellum or brain stem. Code 40 applies, but code 50 or any higher code is not applicable in this case.

    		 2008
    		20081038

    Histology/Primary site: What is the correct histology code for sarcomatoid carcinoma of the mandible diagnosed in 2007? See Discussion.

    Left mandible resection: Malignant tumor, favor high grade sarcomatoid carcinoma. Please see comment.

    Comment: Considering the focal stain with P63 and the consult from Mayo Clinic done on the previous biopsy, the diagnosis of sarcomatoid carcinoma is more likely.

    Gross: left mandible resection...sectioning reveals a...mass that has replaced the majority of the mandibular bone and is at the medial, anterior lateral and posterior soft tissue margins and comes to within 2.4 cm of the anterior boney resection margin and 1.9 cm of the smooth articular temporal mandibular joint surface.

    The combination of C411 and 8033/3 is impossible (with no override available).

    Code the primary site C031 [Mandibular gingiva]. Code the histology 8033 [sarcomatoid carcinoma]. This tumor originated in the mandibular gingiva and invaded the bone (mandible) -- It did not originate in the bone. This type of tumor does not originate in bone.

    		 2008
    		20081139 Date Multiple Tumors--Prostate: For a prostate biopsy done 10/20/08, both lobes involved with tumor, unknown how many tumors, what would be coded in date of multiple tumors? In this case, code the date of the biopsy in Date of Multiple Tumors [10202008]. When the number of tumors is unknown, code the date of diagnosis as the Date of Multiple Tumors. This is the date on which it was determined that there were an unknown number of tumors. This instruction will be added to next edition of the MP/H manual. 2008
    		20081111

    MP/H Rules/Histology--Breast: If an in situ carcinoma diagnosed in 2007 demonstrates comedo necrosis, should the histology be coded to comedocarcinoma in situ? See Discussion.

    According to the new MP/H rules, we code descriptive features. There is no coding guidance or reference to "necrosis" within the breast MP/H rules. Based on SEER SINQ 20021002, the "comedo necrosis" would not be coded at all for pre-2007 cases. Does this still hold true for cases diagnosed after January 1, 2007?

    For cases diagnosed 2007 or later, comedo necrosis is not synonymous with comedocarcinoma. If no further information is available for this case, code as carcinoma in situ.

    		 2008
    		20081046 MP/H Rules--Corpus uteri: How is histology coded for an endometrial tumor described as an "endometrioid adenocarcinoma with prominent squamous metaplasia"?

    For cases diagnosed 2007 or later:

    Endometrioid adenocarcinoma with squamous metaplasia is coded 8570 [Adenocarcinoma with squamous metaplasia]. This falls under the Histology Coding Rules for Other Sites, rule H17. The code for Endometroid adenocarcinoma is 8380. The code for Adenocarcinoma with squamous metaplasia is 8570. The histology with the numerically higher ICD-O-3 code is Adenocarcinoma with squamous metaplasia -- 8570.

    		 2008
    		20081021 Primary Site/Surgery of Other Site--Leukemia: If hairy cell leukemia is diagnosed at splenectomy, and 1 month later a bone marrow confirms the same diagnosis, is the primary site coded to spleen or bone marrow? If the site is bone marrow, is the splenectomy coded to 2 (regional) or 4 (distant) in the surgery field?

    For cases diagnosed prior to 1/1/2010:Primary site:

    Code the primary site to C421 [bone marrow] per primary site coding instructions for leukemia in the 2007 SEER manual, page 70.

    Surgery of other site:

    Since all surgical procedures for hematopoietic diseases are coded in the data item Surgery of Other Site, assign code 1 [Nonprimary surgical procedure performed].

    For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

    		 2008
    		20081086 Reportability: Is a case reportable if a benign diagnosis is obtained on a resection that follows a positive needle aspiration? See Discussion. Fine needle aspiration of the thyroid diagnosis was "positive for malignant cells, favor medullary carcinoma." Subsequent thyroidectomy was reported as benign. This case is reportable. The cytology is positive. Report as medulary carcinoma of the thyroid. 2008