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Smoldering multiple myeloma is reportable. However, it is unclear if a diagnosis of borderline smoldering multiple myeloma should be accessioned when no further follow-up with the physician is possible. The physician stated the patient, "most likely has borderline smoldering multiple myeloma, but mostly MGUS," and further noted the definition of smoldering myeloma requires at least 10% of plasma cells involved with the neoplasm and some areas of the patient's bone marrow does meet the 10% plasma cell threshold. The physician noted the patient does not need treatment because of the favorable cytogenetics and lack of organ dysfunction.

Should the term "borderline" be ignored and the case accessioned? Or is a borderline smoldering myeloma non-reportable?

In 01/2023, right lower lobectomy final diagnosis proved a single adenocarcinoma tumor with the histological patterns described as acinar (20%), papillary (30%) and solid; complex glands (cribriform and fused glands) (50%). There is no H Rule applicable to a complex glandular pattern adenocarcinoma. Is this equivalent to a solid predominant adenocarcinoma (8230) per Rule H7? Or is the predominant adenocarcinoma a mixed subtype coded as 8255 per Rule H9?

Patient had a left thigh soft tissue mass excision on 7/24/24 and was diagnosed with superficial CD34 positive fibroblastic tumor. Margins were narrowly free of disease. Tumor size was 5.5 cm x 4.4 cm x 3.9 cm. The diagnosis was confirmed.

Lymphangioleiomyomatosis (LAM) became reportable (9174/3) for diagnoses 2023 and later. While this neoplasm was only added to the Lung schema in the Solid Tumor Rules manual, this is a mesenchymal neoplasm which may arise outside of the lung and the reportability change was not limited to LAM of the lung.

How should primary site be coded when a left pelvic lymph node dissection for an unrelated high-grade serous carcinoma of the right fallopian tube incidentally proved LAM in the pelvic lymph nodes? The pelvic lymph nodes were the only site of involvement; there was no evidence of lung involvement. As this is a mesenchymal tumor, should the primary site default to C499 (Soft tissue, NOS) according to the default primary site rule for sarcomas described in the SEER Manual? Or should the primary site be coded to C775 (Pelvic lymph nodes) as this was the only proven site of involvement?

CAP Protocol for the Examination of Cystectomy Specimens From Patients With Carcinoma of the Urinary Bladder/Treatment Effect Post Neoadjuvant Chemotherapy (BCG not included) selections

o No known presurgical neoadjuvant therapy

o Complete response: Absence of histologically identifiable residual cancer cells and extensive fibrosis of the tumor bed after presurgical neoadjuvant therapy (TRG1)

o Strong response: Predominant fibrosis of the tumor bed, with residual cancer cells occupying less than 50% of this area (TRG2)

o Weak or no response: Residual cancer cells occupying ≥50% of the tumor bed or absence of regressive changes (TRG3)

o Other (specify): _________________

SEER Coding Instruction for Site-Specific Codes for Neoadjuvant Therapy Treatment Effect - Schemas: All Other Schemas selections

0 Neoadjuvant therapy not given/no known presurgical therapy

1 Complete pathological response

Present: No viable cancer cells/no residual invasive carcinoma identified

Residual in situ carcinoma only

2 Near complete pathological response

Present: Single cells or rare small groups of invasive cancer cells

3 Partial or minimal pathological response

Present: Residual invasive cancer with evident tumor regression, but more than single cells or rare small groups of cancer cells

4 Poor or no pathological response

Absent: Extensive residual cancer with no evident tumor regression

6 Neoadjuvant therapy completed and surgical resection performed, response not documented or unknown

Cannot be determined

7 Neoadjuvant therapy completed and planned surgical resection not performed

9 Unknown if neoadjuvant therapy performed

Unknown if planned surgical procedure performed after completion of neoadjuvant therapy

Death Certificate only (DCO)

In previous STR versions and the ICD-O-3.2, SFT/hemangiopericytoma, WHO G1 is 8815/0 and only SFT/hemangiopericytoma, WHO G2 was 8815/1. However, Table 6 (Non-Malignant CNS, Specific Histologies, NOS, and Subtypes/Variants) was changed in the 2025 updates to indicate both G1 and G2 SFT/hemangiopericytoma are 8815/1.

No date range was provided for this change in the STR and the behavior of this tumor was not updated by the standard setters in other references (i.e., ICD-O-3.2). The behavior of G1 SFT/hemangiopericytoma was not updated in the 2025 ICD-O-3.2 updates. If the ICD-O-3.2 was the source of this change, should this have been documented in the 2025 NAACCR Implementation Guidelines? However, the 2025 NAACCR Implementation Guidelines indicates, "There are no ICD-O-3 changes for 2025." Is this behavior change in 2025 Solid Tumor Rules updates an error? Should the behavior of SFT/hemangiopericytoma, WHO G1 remain /0? 

According to the AJCC CAnswer Forum (https://cancerbulletin.facs.org/forums/node/160948), celiac axis nodes are considered regional for the liver. However, for liver primaries, Extent of Disease (EOD) regional lymph nodes list the following as regional lymph nodes:

• Caval
• Hepatic, NOS
  • Hepatic artery
  • Hepatic pedicle
  • Inferior vena cava
  • Porta hepatis (portal) (hilar) [in hilus of liver]
• Periportal
• Portal vein
• Regional lymph node(s), NOS

Based on this information, should celiac axis lymph nodes be considered as regional for liver primaries when coding EOD Regional Nodes?