MP/H Rules/Histology: What is the correct histology code for a NUT midline carcinoma?
Code histology to 8010/3.
NUT carcinoma is identified by the NUTM1 gene rearrangement.
NUT midline carcinomas (NMC) are lethal and morphologically indistinguishable from other poorly diff carcinomas. They are epithelial tumors which can range from undifferentiated carcinomas to carcinomas with prominent squamous differentiation.
A new proposed ICD-O-3 code has been suggested for NUT tumors but it is not yet approved for implementation. Do not use the new code until it is approved for use in the United States.
Reportability--Brain and CNS: Are sphenoid wing meningiomas reportable? See discussion.
It's my understanding that true intraosseous meningiomas are very rare. It's also my understanding that cranial meninges DO cover the sphenoid wing, so I'm wondering if it's possible to have a meningioma of the sphenoid wing on imaging that arises from the meninges NOT the bone. Is that the deciding factor on reportability? It's been suggested to me that meninges cells do lie within the bone, but again if a meningioma is described as being located at the sphenoid wing on imaging, without bone involvement - and no surgery is performed - I do not understand why it is specifically excluded as non-reportable.
This answer pertains to cases diagnosed prior to 2018. For 2018 and later cases, refer to the Non-Malignant CNS Solid Tumor Rules.
Note: This answer updates previous answers which have been removed from the SEER Inquiry System.
Intraosseous meningiomas are not reportable. You are correct, these are rare meningiomas originating in bone. The term "sphenoid wing meningioma" is sometimes used for an intraosseous meningioma of the sphenoid bone. Yes, it's possible to have a meningioma of the sphenoid wing on imaging that arises from the meninges NOT the bone. Read the available information carefully. When the site of origin is described as "along the sphenoid wing" or "overlying the sphenoid wing" report the meningioma. These descriptions indicate that the meningioma originates from the meninges covering bone rather than the bone itself. Meningioma arising in bone is rare enough, that when present, we would expect it to be clearly stated as such. In the absence of a statement indicating origin in bone, the meningioma is most likely arising from meninges covering the bone.
MP/H Rules/Histology--Brain and CNS: What is the code for Rosette-forming glioneural tumor from a pathology report of a brain tumor biopsy for a date of diagnosis in 2015? See Discussion.
Assign 9505/1 for Rosette-forming glioneuronal tumor. The new code, 9509/1, has not been implemented in the United States. 9505/1 is to be used until the new code is implemented. See page 7 of the NAACCR Guidelines for ICD-O-D Implementation, effective January 1, 2014, http://www.naaccr.org/LinkClick.aspx?fileticket=u7d3sB71t5w%3d&tabid=126&mid=466.
Surgery of Primary Site--Breast: If the diagnosis is a single primary involving both breasts, do we code 41 Surgery Primary site with 1 in Surgery Other site, or code 76 Surgery Primary site with 0 in Surgery Other site? See discussion.
In Appendix C- Breast (SEER Manual 2015) it states under the codes for TOTAL MASTECTOMY (Codes 40-49, 75): For single primaries only, code removal of involved contralateral breast under the data item Surgical Procedure/Other Site (NAACCR Item # 1294). [SEER Note: Example of single primary with removal of involved contralateral breast--Inflammatory carcinoma involving both breasts. Bilateral simple mastectomies. Code Surgery of Primary Site 41 and code Surgical Procedure of Other Site 1.] HOWEVER, underneath that it states code 76 is used for: 76 Bilateral mastectomy for a single tumor involving both breasts, as for bilateral inflammatory carcinoma. So
Assign code 41 with 1 in surgery other site for simple mastectomy. Assign code 76 with 0 in surgery other site for a more extensive mastectomy.
Grade/Sarcoma--Breast: Is the correct grade for high grade angiosarcoma of the breast a code 3 or 4? The breast usually uses a three grade system but sarcoma is not a typical histologic type of the breast.
Assign grade code 4 using the sarcoma table. Nottingham or Bloom-Richardson (BR) Score/Grade does not apply to angiosarcomas. This is a good question and points out needed clarification of the grade rules.
Reportability--Brain and CNS: Is a thalamic amyloidoma reportable if so what histology code is used?
Thalamic amyloidoma is not reportable. Amyloidoma (tumoral amyloidosis, amyloid tumor) is a tumor-like deposit of amyloid. It is not neoplastic. Amyloid is a protein derived substance deposited in various clinical settings.
Would this situation be 2 primaries - 1993 Renal pelvis and 1994 Bladder with the 2015 being the same primary as 1993 Renal pelvis? Or 3 primaries - 1993 Renal pelvis, 1994 Bladder, 2015 Bladder?
Abstract four primaries, 1993 renal pelvis, 1994 bladder, 2013 bladder, and 2015 bladder.
For the remaining diagnoses, the 2007 MP/H rules apply. The 2013 bladder diagnosis is a new primary per rule M7. The 2014 bladder diagnosis is not a new primary per rule M6. The 2015 bladder diagnosis is a new primary per rule M5.
Reportability--Gallbladder: Is high grade biliary intraepithelial neoplasia of the gallbladder reportable?
High grade biliary intraepithelial neoplasia of the gallbladder is reportable. Assign code 8148/2. It is also known as biliary intraepithelial neoplasia grade 3, or BilIN-3.
Surgery of primary site--Lung: Should microwave ablation be coded as treatment for lung cancer, and if so, how should it be coded?
Code microwave tumor ablation as surgery. For lung, assign code 15.
This question was discussed by the technical advisory group – a small group of representatives from each standard setter which meets periodically. The group agreed on this consensus answer.
Grade--Kidney: Should WHO/ISUP grade for renal cell carcinoma be coded for cases diagnosed 2016 and later? See discussion.
The 2016 WHO Classification of Tumours of the Urinary System appears to be moving away from using Fuhrman grading toward using WHO/ISUP grade. These seem like similar 4 grade staging systems; however, the SEER Manual specifically states to not use the Special Grade System table for WHO/ISUP. We are seeing the WHO/ISUP grade being used on 2016 pathology reports.
Examples of new grading for renal cell carcinomas
Histologic type: Clear cell renal cell carcinoma
Histologic grade (WHO/ISUP 2016): Grade 3 in a background of 2 (of 4).
And
Histologic type: Clear cell renal cell carcinoma
Histologic grade (ISUP): Grade 2.
Do not record WHO/ISUP grade in the grade/differentiation field.
Designated fields for this grade system are being proposed for future implementation.