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For cases diagnosed 2007 or later:

This is a single primary with renal pelvis as primary site.

Use the 2007 MP/H rules to determine if the 2007 diagnosis is a new primary. Use the Urinary rules, multiple tumors module. Start with rule M3. Follow the rules down to Rule M8 and stop. This is an example of implantation effect.

For cases diagnosed prior to 2013:

For tumors diagnosed prior to 2007, this is one primary, assuming these are wider excisions of the same tumor.

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

Code Radiation (Rx Summ--Radiation) to 0 [None; diagnosed at autopsy].

SEER does not collect the Reason For No Radiation field. However, those who abstract using software that captures this data item can identify these cases. Code 5 [radiation not administered because patient died] reflects this situation.

Radiation (Rx Summ-Radiation) is a SEER field. This field is derived from the data collected in Rad-Boost Rx Modality and Rad-Regional TX Modality. These fields do not include a choice for "radiation not given because the patient died prior to treatment." Therefore, this information cannot be coded in the Radiation field.

For cases diagnosed 2007 or later:

When there is a single tumor in one lung and a single tumor in the other lung, apply rule M6 and abstract as multiple primaries. Use this rule whenever there is a single tumor in each lung, even when neither tumor is biopsied or resected.

This rule is unique to lung. Our physician advisors emphasized that it is very unlikely that a single tumor in one lung could be metastatic from a single tumor in the opposite lung. Therefore, the default is to abstract as multiple primaries.

The note at M6 means that there must be proof that one tumor is metastatic in order to abstract as a single primary. For example, a biopsy of the tumor proving that it is metastatic. An opinion or belief that one tumor is metastatic is not sufficient. In the absence of proof, use rule M6 and abstract as multiple primaries.

A list of MP/H clarifications will be available. This issue will be included on the list.

For cases diagnosed 2007 or later, code the histology 8523 [duct mixed with other types of carcinoma].

After determining that the invasive histology is to be coded using rule H9, there is another decision to make in this case -- which invasive histology should be coded? Make a second pass through the histology rules, begining with rule H10. Stop at H17 and code 8523.

This advanced concept of a "second pass" through the rules is discussed in an online web training session called "Beyond the basics." Go to the SEER website to view this session http://www.seer.cancer.gov/tools/mphrules/training_advanced.html

For cases diagnosed 2007 or later:

For coding purposes, this is a papillary and follicular combination that would be coded to the combination code 8340/3 [Papillary carcinoma, follicular variant].

For thyroid cancer only, the term micropapillary does not refer to a specific histologic type. It means that the papillary portion of the tumor is minimal or occult, usually less than 1 cm. in diameter.

For cases diagnosed 2007 or later:

There are two primaries. Primary 1: The two tumors described on the pathology report from the lumpectomy are a single primary using rule M13. Primary 2: Disregard the foci of residual DCIS. Paget disease of the nipple is a separate primary using rule M12.

Primary 1: invasive mucinous adenocarcinoma and extensive ductal carcinoma in situ: Code the histology as 8480/3 [mucinous adenocarcinoma] using rule H27.

Primary 2: Paget disease of nipple: Code the histology as 8540/3 [Paget disease] using rule H14.