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Do not code as a treatment. Record the cessation of immunosuppressive drug treatment in text to explain the patient’s change in disease status.

Do not use the NME size from magnetic resonance imaging (MRI) to code tumor size when both tumor size and NME size are stated or if NME is the only size available. The size of the solid tumor mass takes priority over the size of the NME when provided separately and the NME is larger.

The American College of Radiology, Breast Imaging Reporting and Data System (BI-RADS) defines NME as an area of enhancement on MRI that does not belong to a 3D mass or have distinct features of a mass. It is a separate descriptor from size that includes modifiers describing enhancement patterns with a specific MRI pattern.

Code dexamethasone in KRd regimen (and any other regimen for multiple myeloma containing dexamethasone) as hormonal therapy. Please note that majority of the regimens for multiple myeloma are not in SEER*Rx currently.

The SEER*Rx entry for KRd regimen was updated to indicate that dexamethasone should be coded. The change was done to correct the contradiction with the SEER manual which states, "Code the hormonal agent given as part of combination chemotherapy (e.g., R-CHOP), whether it affects the cancer cells or not" and the SEER*Rx entry for dexamethasone which directs to code it for multiple myeloma.

Code 550 is missing “< equal to 6 cm.” In addition, code 650 should include ipsilateral lymph nodes as well.

Revised codes:

Code 550

CLINICAL ASSESSMENT only

Bilateral or contralateral lymph nodes, < equal to 6 cm WITH clinical evidence of ENE

Code 650

CLINICAL ASSESSMENT only

Ipsilateral, Bilateral or Contralateral lymph nodes > 6 cm WITH or WITHOUT clinical evidence of ENE

These changes will be implemented in Version 3.4 (October 2026). We apologize for the error.

Report the case when the differential diagnosis includes only reportable neoplasms in the absence of additional information. We are unable to provide general instructions for provisional diagnoses as each situation will need to be reviewed and assessed individually when no further work-up information is available.

Assign myeloid leukemia, NOS (9860/3) to the case described in the example. Assign a generic histology code because a specific histology code cannot be assigned when there are several differential diagnoses. Since the differential diagnoses include a chronic and an acute leukemia, code as myeloid leukemia, NOS since it is not clear if this is chronic or acute.

Do not include the disease in the sequencing if the original hematolymphoid disease was not reportable at time of diagnosis.

The 2025 SEER Manual Sequence Number--Central Coding Instruction 1.a advises: A ‘reportable’ primary refers to the site/histology/behavior of the tumor and the years when reporting was required. Review of the reportability requirements in effect during the diagnosis year will be needed.

Without evidence of a new testicular tumor, record this as a single primary now with metastatic disease (seminoma). The seminoma may not have been identified in the original tumor and treatment was based on the histologies found. This allowed the seminoma to metastasize.

High grade squamous dysplasia (8077/2) is reportable for head and neck sites for cases diagnosed as of 01/01/2021. High grade glandular intraepithelial neoplasia / glandular intraepithelial neoplasia grade III (8148/2) and high grade squamous intraepithelial neoplasia / squamous intraepithelial neoplasia grade III (8077/2) are reportable for head and neck sites for cases diagnosed as of 01/01/2001. Refer to other standard setters’ criteria for reportability as appropriate.

Histology code 8255/3 best identifies this histology. Complex glands in lung tumors are often associated with a poor prognosis and represent a high-grade pattern in lung cancer grading systems. This histology is not currently recognized as a variant by WHO.