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Report Produced: 02/25/2026 11:06 AM

Report Question ID Question Discussion Answer Year
20140029

MP/H Rules/Histology-Urinary: 1) What is the correct ICD-O-3 morphology code for conventional renal cell carcinoma? Is this clear cell carcinoma or does conventional refer to the general diagnosis?

2) If a patient was diagnosed with invasive papillary urothelial carcinoma of the bladder in May 2011 and returns in February 2013 with invasive urothelial carcinoma of the bladder, what is the correct ICD-O-3 morphology code?

1) Clear cell renal carcinoma, code 8310, is often called conventional renal cell carcinoma. It is specific compared to renal cell carcinoma, NOS, code 8312, a general morphology term for the majority of kidney cancers. See  kidney rules H5 and H12 and Table 1 on page 57 of the Kidney Terms and Definitions, http://www.seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf

2) Do not change the ICD-O-3 code assigned for the 2011 diagnosis. As you know, the 2013 diagnosis is not a new primary per rule M6.

2014
20140030

MP/H Rules/Multiple primaries--Bladder: Is this a single primary or multiple primaries? Transurethral resection of the bladder identifies two bladder tumors. Pathology states one is high grade papillary carcinoma (8130/3) and the other is lymphoepithelioma-like urothelial carcinoma (8082/3). Lymphoepithelioma-like is listed as a urothelial type in Table 1 but rule M6 does not include it in the list of histologies and we are not told to refer to Table 1. M8 refers to Table 1 but does not include multiple bladder tumors (C67_). Specify which rule would apply and why.

Rule M9 applies to this case. Abstract two primaries. M6 does not apply to this case because code 8082 is not one of the applicable histology codes for M6. This situation will be reviewed as we prepare the next version of the rules.

2014
20140027

MP/H Rules/Histology--Bladder: What is the correct histology for the following bladder case and how do you determine? See discussion.

8/1/10 CYSTOSCOPY -- MULTIPLE BLADDER TUMORS INVOLVING POSTERIOR WALL, DOME & BLADDER NECK AREA. LARGEST WOULD BE MORE THAN 5 CM IN SIZE. 8/17/10 path -- BLADDER TUMORS:PAPILLARY TRANSITIONAL CELL CARCINOMA OF urinary bladder, GRADE III. ONE FRAGMENT OF TISSUE SHOWS NECROTIC CHANGE WITH APPARENT TRANSFORMATION TO A HIGH GRADE SARCOMATOID VARIANT W ITH EXTENSIVE SUBMUCOSAL INVASION & FOCAL AREA SUGGESTIVE OF ANGIOLYMPHATIC INVASION NOTED. MAJORITY OF TUMOR APPEARS CONFINED TO MUCOSAL SURFACE W ITH NO OTHER AREAS OF DEFINITIVE SUBMUCOSAL INVASION FOUND.

Code 8122/3 (UC/TCC, Sarcomatoid). Rule H5 and Table 1 apply.

This is based on the information provided: Transitional Cell Carcinoma with sarcomatoid variant, and Table 1 in Terms and Definitions for "Ureter/Renal Pelvis/Bladder".

2014
20140080

Behavior--Breast: Is behavior for encapsulated papillary carcinoma (EPC) of the breast coded as noninvasive or invasive?

The pathologist has the final say on behavior. Code behavior based on the pathologist's final diagnosis. See Rule F in ICD-O-3.

According the WHO Classification of Breast Tumors, encapsulated papillary carcinoma of the breast is in situ, /2. Encapsulated papillary carcinoma with invasion is assigned /3. WHO describes "frank invasive carcinoma" for this histology as "neoplastic epithelial elements infiltrate beyond the fibrous capsule of encapsulated papillary carcinomas." WHO cautions that true infiltration should be "differentiated from entrapment of neoplastic epithelial cells in the fibrous capsule and from epithelial displacement into the biopsy site, which is frequently encountered following needle-core procedures of papillary lesions."

2014
20140046

MP/H/Multiple Primaries--Urinary: Is this one primary with a C689 primary code and morphology 8130/3? Or is this 2 primaries: 1. C679 8130/3 and 2.C680 8120/2. See discussion.

Urinary: Transitional Cell Carcinoma and open prostatectomy: Path from Bladder: Papillary and solid transitional cell carcinoma of bladder - grade II and III Stage A.

Path from prostatectomy: The prostatic tissue samples shows areas of urothelia carcinoma in situ - related to the tumor present in the bladder.

Conclusion: Prostatectomy showing foci of transitional cell carcinoma in situ of prostatic urethra.

Abstract a single primary, C679 8130/3. Rules M2 and H4 apply. Transitional cell/urothelial carcinoma in the prostatic urethra is likely an extension from the known bladder TCC in this case, not a separate primary. See prostatic urethra on page 63 in the Urinary Terms and Definitions, http://www.seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf

2014
20140070

Reportability--Pancreas: Is this reportable? Is this benign? If reportable, what histology code and behavior code should be used? A final pathology diagnosis reads: "Cystic pancreatic endocrine neoplasm (CPEN)".

"Cystic pancreatic endocrine neoplasm (CPEN)" is reportable. Assign 8150/3 based on the information provided. We consulted our expert pathologist and he states "Since metastases have been reported in a few, and all the rest of the pancreatic endocrine tumors are now designated malignant, …we are safe considering them /3 until proven otherwise. Since most of them are non-functioning, [assign code] 8150/3 unless specified as to G1 (8240/3) or G2 (8249/3)."

2014
20140013 Primary site--Brain and CNS: How should primary site be coded for a medulloblastoma described as a "posterior fossa mass" and "centered within the fourth ventricle"? See discussion. The associated site code for medulloblastoma in the ICD-O-3 is C716. However, the SEER Manual specifically instructs to ignore the associated site code if a different primary site is noted. Although most medulloblastomas appear to arise in the cerebellum, when described as "centered within the fourth ventricle" can we assume that is the primary site and not simply invasion of the fourth ventricle from the cerebellum?

Code the primary to C717 for this case.

Code the primary site according to the origin of a particular medulloblastoma when it differs from the site code listed in ICD-O-3. The description "centered within the fourth ventricle" suggests that this medulloblastoma originated in the fourth ventricle.

 2014
20140086

MP/H Rules/Multiple primaries--Colon: Does rule M7 apply here (A frank malignant or in situ adenocarcinoma and an in situ or malignant tumor in a polyp are a single primary)? Can the frank malignant adenocarcinoma be any specific type of adenocarcinoma for this rule to apply?

A patient has 2 synchronous tumors in the ascending colon. The first is grade 3 adenocarcinoma with signet ring differentiation and focal mucinous features (8255/3). The second is grade 2-3 adenocarcinoma in a tubulovillous adenoma (8263/3).

M7 applies to this case. The frank adenocarcinoma can be a specific type of adenocarcinoma.

2014
20140014 First course treatment/Surgery of Primary Site--Anus: Would infrared coagulation be coded as treatment for AIN III of the anus/anal canal? See discussion. SINQ 20051064 indicates infrared coagulation is not treatment for cancer. Internet search explains that infrared coagulation delivers heat to destroy the tissue so it can be removed. In our region it is currently used to treat internal and external anal low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL). While it is understandable that this wouldn't be coded as treatment for an invasive anal primary, could it be treatment for an in situ tumor? If it is treatment, should it be coded under Surgery code 15 The answer to SINQ 20050164 still applies. Do not code infrared coagulation as cancer treatment. It is used to coagulate blood vessels and not to destroy cancer tissue. 2014
20140011 MP/H Rules/Multiple primaries--Breast: Is the diagnosis of Paget disease two years after a diagnosis of infiltrating duct carcinoma of the same breast a new primary? See discussion. A patient was diagnosed and treated in 2010 for infiltrating duct carcinoma of the left breast. There was no mention of Paget disease. Then in 2012, the same patient was diagnosed with Paget disease of the nipple of the left breast. Rule M9 seems to apply; so this is the same primary, correct? And the information about the Paget disease is simply never captured, correct? Yes, Rule M9 makes this a single primary. You could revise the original histology code to 8541/3 on the assumption that Paget was present at the original diagnosis, but not yet identified. 2014