Report | Question ID | Question | Discussion | Answer | Year |
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20180061 | Primary Site: How should primary site be coded when there is an invasive tumor in one subsite and an in situ tumor in another subsite of the breast? See Discussion. |
The previous SEER Program Coding and Staging Manual included Appendix C that has Coding Guidelines for some sites. The breast guidelines specifically instructed one to code the subsite with the invasive tumor when the pathology report identifies invasive tumor in one subsite and in situ tumor in a different subsite or subsites. The current Breast Solid Tumor Rules Table 1: Primary Site Codes refers one back to the SEER Manual and COC Manual for a source document priority list but does not make mention of invasive vs. in situ on that final version of the source document. In addition, the Colon Solid Tumor Rules currently contains no Site Coding Section/Table. However, the Lung Solid Tumor Rules do and also refer one to the SEER/COC Manuals for document priority lists. The Urinary Solid Tumor Rules has both the Primary Site Codes Table and an additional section called Priority for Coding Primary Site, which does not reference a document priority list or other manuals. Unfortunately, there is additional information in Appendix C Bladder Coding Guidelines that may have been used in the past regarding site source priority. Could the remaining applicable Appendix C information be consolidated into the Solid Tumor Rules consistently among all the sites to lessen the need for additional manual referencing? Also, is there a reason one site includes the Priority Site Coding instructions and others do not? |
Code the subsite with the invasive tumor as the primary site when the pathology report identifies invasive tumor in one subsite and in situ tumor in a different subsite or subsites as stated in Appendix C, Breast Coding Guidelines, 2018 SEER Program Coding and Staging Manual. This statement is unchanged from the previous version; however, the priority list was modified for coding a subsite when there is conflicting information. The focus of the Solid Tumor Rules is to differentiate between single vs. multiple primaries and to assist with identifying the appropriate histology code. The site tables in the solid tumor rules are a reference only. The site-specific Coding Guidelines assist with additional considerations when abstracting cases. |
2018 |
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20180015 | Histology--Ovary: What is the correct ICD-O-3 histology code for sertoliform endometrioid carcinoma of the ovary? |
Assign 8380/3. Sertoliform endometrioid carcinoma is a variant of endometrioid carcinoma according to the WHO Classification of Tumors of Female Reproductive Organs, 4th edition. There is no specific ICD-O-3 code for this variant. |
2018 | |
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20180097 | Reportability/Histology--Liver: Are primary hepatic neuroendocrine neoplasm and primary hepatic neuroendocrine tumor (PHNET) reportable? What are the specific histology codes? |
Primary hepatic neuroendocrine tumor (PHNET) is reportable as are other digestive system NETs. There is no specific histology code for PHNET. We suggest you assign 8240/3. Use text fields to document the details. Unless you can obtain clarification, do not report primary hepatic neuroendocrine neoplasm with no further information. If this term is being used as a synonym for PHNET, document this in the registry's policies and procedures, and report these cases. |
2018 | |
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20180009 | Reportability--Head & Neck: Is dentinoameloblastoma reportable, and if so, what is the correct histology code? See Discussion. |
Mixed odontogenic tumor consistent with dentinoameloblastoma, 9.5 cm, See Note: Tumor involves maxillary bone including hard palate, alveolar ridges, nasal cavities and maxillary sinuses bilaterally and buccal soft tissue. Lymphovascular invasion not identified. Perineural invasion not identified. Margins: Tumor involves right posterior bone (alveolar) margin. All other margins negative. Note: This is a rare hybrid tumor showing features of ameloblastoma producing pre-dentin/osteodentin matrix. Submucosal tumor is seen in the nasal cavities and palate. A congo red stain shows that the acellular dentin-like matrix fluoresces similar to collagen after polarization. Immunohistochemistry shows that the tumor cells are diffusely and strongly positive for p63, focally positive for CK19, and negative for CK5/6, SOX10, S100 and calretinin. |
Dentinoameloblastoma is not reportable. It is a variant of ameloblastoma which produces dentin and/or osteoid. It is benign. It can extend locally in a rather aggressive fashion, but is not given a malignant designation unless it metastasizes. |
2018 |
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20180012 | First course of treatment: What is the correct code to use for allogenic stem cell transplant? |
Code an allogenic stem cell transplant as 20 (Stem cell harvest (stem cell transplant) and infusion) in Hematologic Transplant and Endocrine Procedures in the 2016 SEER Manual. |
2018 | |
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20180094 | Reportability--Prostate: According to the 2018 SEER Program Manual, a prostatic intraepithelial neoplasia (PIN) III is not reportable, but is an atypical small acinar proliferation (ASAP) PIN 4 reportable? |
ASAP is not reportable. Patients with ASAP found on needle biopsy will likely undergo another biopsy. |
2018 | |
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20180040 | Reportability--Kidney: Is congenital cellular mesoblastic nephroma reportable for a newborn baby? See discussion. |
2015 Rt kidney nephrectomy pathology states: congenital cellular mesoblastic nephroma, tumor sz 5.9cm, tumor limited to kidney, extension into pelvicalyceal system, margin not applicable, LVI negative. Per PubMed.gov: (In newborns) among the low-grade malignant tumors, congenital mesoblastic nephromas can be successfully treated with simple nephrectomy. Per ScienceDirect: ...currently thought that cellular mesoblastic nephroma is actually a renal variant of infantile fibrosarcoma. |
Do not report congenital mesoblastic nephroma (8960/1). Congenital mesoblastic mephromas are low-grade fibroblastic neoplasms of the infantile renal sinus according to WHO Classification of Tumors of the Urinary System and Male Genital Organs. The WHO classification is the standard used to determine behavior and histology for entities not listed in ICD-O-3. |
2018 |
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20180083 | Solid Tumor Rules (2018)/Multiple primaries--Bladder: How many primaries are abstracted and which M Rule applies when a patient is diagnosed with an invasive urothelial carcinoma tumor of the bladder, followed less than three years later by an invasive urothelial carcinoma and small cell neuroendocrine carcinoma tumor of the bladder? See Discussion. |
The Solid Tumor Rules indicate bladder tumors that are urothelial carcinoma (8120) and small cell carcinoma (8041) are separate primaries per Rule M13 (Abstract multiple primaries when separate/non-contiguous tumors are on different rows in Table 2). These are distinctly different histologies and, presumably, one would want to capture the small cell carcinoma (or small cell carcinoma component) as this has a worse prognosis. However, if a subsequent bladder tumor is composed of invasive urothelial carcinoma and small cell neuroendocrine carcinoma, the histology is coded as 8045/3 per Rule H4, but this is not abstracted as a multiple primary. The only M Rule that applies is Rule M18 (Abstract a single primary when tumors do not meet any of the above criteria). The mixed histology code 8045 is not included in Table 2, so none of the histology-based M Rules apply. Is the subsequent mixed invasive urothelial and small cell carcinoma tumor (8045/3) the same primary as a previously diagnosed invasive urothelial carcinoma (8120/3) when these tumors are diagnosed within three years? |
Abstract two separate primaries using Solid Tumor Rules Urinary Sites Rule M13. While not stated in the urinary sites rules, these are separate histology codes in two different rows in Table 2 of the Rules. The initial histology is 8120 and the subsequent tumor is 8045 using Rule H4. Adding 8045 to Table 2 will cause issues. Small cell neuroendocrine in the bladder is very rare, extremely aggressive, and usually has a component of urothelial carcinoma. |
2018 |
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20180038 | Multiple Primaries--Heme & Lymphoid Neoplasms: How many primaries should be reported when a 10/10/2017 skin biopsy identified myeloid sarcoma with monocytic differentiation, clinically stated to be leukemia cutis is followed by an 11/2/2017 BM biopsy showing an evolving high grade myelodysplastic process with atypical monocytes, likely an early evolving acute myeloid leukemia (AML), clinically stated to be a therapy-related AML (9920/3)? See Discussion. |
Code 9920/3 is not included under rule M3. However, disease process knowledge would indicate that because the patient has an underlying AML subtype, the leukemia cutis is due to the AML cells that have migrated into the skin tissue. This appears to be a single advanced disease process essentially diagnosed simultaneously. |
The leukemia cutis is secondary to leukemia that is already present. This is multiple disease processes going on at the same time. Look for more information on this case. Is there any previous diagnosis of MDS, leukemia, or some other disease that would result in a treatment related AML? If no further information can be found, abstract one primary with 9920/3. |
2018 |
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20180032 | Reportability--Appendix: Is low grade appendiceal mucinous neoplasm (LAMN) reportable for 2018? It is staged as pTis(LAMN) AJCC 8th ed by pathologist. |
Low grade appendiceal mucinous neoplasm (LAMN) is not reportable in 2018. See page 6, https://20tqtx36s1la18rvn82wcmpn-wpengine.netdna-ssl.com/wp-content/uploads/2018/02/2018-ICD-O-3-Coding-Table-Alpha-order-.pdf. Use cancer registry reportability instructions to determine reportability. Do not use the AJCC TNM manual to determine reportability. |
2018 |