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The NAACCR Guidelines for ICD-O-3 Histology Code and Behavior Update Implementation, effective January 1, 2018, state: Currently in ICD-O-3, when a topography (C code) is listed in parentheses next to the morphology term, it indicates morphology is most common to that site. It may occur in other sites as well. Many of the new codes, terms, and behaviors listed in this update are site-specific and do not apply to all sites.

Please review the Comments to determine which histology codes are specific to sites. You may use sites not listed as the suggested site; however, it will generate an edit error for review and verification of the appropriate site.

For mesothelioma, NOS (9050) and epithelioid mesothelioma (9052) of the peritoneum for females, assign C481, C482, or C488 as appropriate based on the site of origin in the medical documentation. The Primary Peritoneal Ca schema is assigned and you will need to complete the SSDIs for FIGO staging, CA-125 PreTx Interpretation, and Residual Tumor Volume Post Cytoreduction.

If the histology is 9051 or 9053 with primary site of C481, C482, or C488 for females, the Retroperitoneum schema is assigned. The only SSDI for this schema is Bone Invasion.

Code EOD Primary Tumor using the post neoadjuvant information for this case. Since the only information you have is the post neoadjuvant, code that. EOD combines clinical and pathological information.

Code Urinary System NOS C689 for this case since there are two separate urinary sites involved. Apply instruction #4 when there is a mix of in situ and invasive urothelial tumors.

See the SEER coding guidelines for breast, https://seer.cancer.gov/manuals/2018/AppendixC/Coding_Guidelines_Breast_2018.pdf Generally, codes C502 - C505 are preferred over C501. C501 would be preferred over C508. Apply these general guidelines when there is no other way to determine the subsite using the available medical documentation.

Table 1, Primary Site codes, in the breast solid tumor rules also provide helpful information for coding site.

Penile intraepithelial neoplasia, grade III (PeIN III) and squamous cell carcinoma in situ of the penis are reportable. If possible, query the physicians as to whether "high grade penile intraepithelial lesion" or are synonymous with one of the reportable terms. If no further information can be obtained, report the case as C609 8077/2, and use text fields to document the details.

Smoldering systemic mastocytosis is reportable, 9741/3. Indolent systemic mastocytosis is not reportable as of cases diagnosed 2018, 9741/1.

Smoldering systemic mastocytosis and indolent systemic mastocytosis are not synonymous. Smoldering differs from indolent based on diagnostic criteria and burden of disease; indolent is low whereas smoldering is high burden of disease that can progress to aggressive systemic mastocytosis or mast cell leukemia.

We will update SINQ 20130134.

Note: this is an update to the 2018 SEER manual.

Assign 999 in Pathologic Tumor Size when neoadjuvant therapy has been administered. We can explore the possibility of another data item in the future.

In the CAP protocol, the term Histologic Type is a label where the histology that corresponds to the largest carcinoma is collected. According to the CAP protocol for invasive breast cancer, the histologic type corresponds to the largest carcinoma. If there are smaller carcinomas of a different type, this information should be included under "Additional Pathologic Findings." The findings noted in the Final Diagnosis, Histologic Type, and Additional Path Findings of the protocol should be used to determine the histology.

When there are multiple histologies and

1) the subtype or variant is listed as 90% when there is a Not Otherwise Specified/No Specific Type (NOS/NST) and a subtype, or

2) the subtype/variant histology reflects the majority of the tumor when there are two or more different histologies (two or more distinct subtypes)

Code the subtype/variant; otherwise, use the Specific and Not Otherwise Specified/No Specific Type (NOS/NST) Terms and Code listed in Table 2 (columns 1 and 2) of the 2018 Solid Tumor Rules for Breast Cancer.

Ovarian serous borderline tumor with node implants is not reportable; it is a borderline neoplasm. However, if the oncologist believes he or she is dealing with a low grade serous carcinoma rather than a borderline tumor, this case is reportable. We recommend that you determine whether the diagnosis of low grade serous carcinoma, chemotherapy not recommended, is based on the pathological findings or on something else before reporting this case.