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Report Produced: 02/24/2026 13:34 PM

Report Question ID Question Discussion Answer Year
20140083

MP/H Rules/Multiple primaries--Thyroid: How many primaries should be reported when a complete thyroidectomy specimen shows two tumors: 1.8 cm papillary carcinoma with tall cell features (8344/3) and a 0.4 cm papillary thyroid carcinoma (8260/3)? See discussion.

Is papillary thyroid carcinoma an NOS histology qualifying for rule M16, thus leading to a single primary, or would M17 apply (multiple primaries) because the histology codes are different at the second digit (8260 and 8344)? While rule M16 doesn't include papillary thyroid carcinoma in the listed histologies, it seems like it may be an NOS histology for the thyroid. In addition, code 8260/3 is listed as NOS in the ICD-O-3.

Apply rule M16 and abstract a single primary. These two thyroid tumors, one papillary carcinoma with tall cell features (8344/3) and one papillary thyroid carcinoma, fit the criteria for rule M16, although not explicity listed there. We will clarify this in the next version of the rules.

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
20140058

Reportability--Pancreas: Is a solid pseudopapillary neoplasm of the pancreas reportable?

Solid pseudopapillary neoplasm of the pancreas is reportable. According to the WHO classification, it is a "low-grade malignant neoplasm…[which] frequently undergoes hemorrhagic-cystic degeneration and occurs predominantly in young women."

Assign topography code C25 with the appropriate 4th digit. Code the histology as 8452/3.

2014
20140006 Date Therapy Initiated--Corpus Uteri: How should this field be coded for an endometrial primary when the patient undergoes a hysteroscopic polypectomy on 01/08/2014 (Surgery code 25), followed by a TAH/BSO on 02/07/2014 (Surgery code 50)? See discussion. The hysteroscopic polypectomy showed multiple tissue fragments with invasive endometrioid adenocarcinoma. The hysterectomy and BSO removed an 8.2cm endometrioid carcinoma with no extra-uterine involvement. Record 01/08/2014 for date therapy initiated assuming there was no therapy prior to this date. A polypectomy is a surgical procedure for purposes of coding date therapy initiated. 2014
20140089

Multiple primaries--Heme & Lymphoid Neoplasms: Should the 2014 diagnosis be abstracted as a new primary since it is not mantle cell lymphoma and all of the types listed in the differential diagnosis would be a new primary? See discussion.

Mantle cell lymphoma diagnosed in 1997 which was treated with chemotherapy. Now in 2014 a 'relapse' of non-Hodgkin lymphoma. They do a biopsy of the pericardium, which is called low grade B cell non Hodgkin lymphoma. See comment. The comment says histochemical stains are reviewed and findings are consistent with involvement by a CD5 positive low grade B cell lymphoma. Lack of cyclin D1 and SOX-11 positivity as well as negative IGH-CCND1 FISH analysis essentially rule out mantle cell lymphoma. The morphologic and immunophenotypic features of this disorder are not specific for any lymphoma subtype. The differential includes CLL, marginal zone lymphoma, and lymphoplasmacytic lymphoma. If this is coded NHL, NOS (9591) it is the same primary as seq. 1 and would not be abstracted.

This is the same primary, the mantle cell lymphoma.

Differential diagnoses cannot be used to assign histology. For the 2014 diagnosis, the only histology that can be assigned is 9591/3 for non-Hodgkin lymphoma, NOS. (CLL, mantle cell lymphoma and lymphoplasmacytic lymphoma are all NHL's.)

Compare the 1997 diganosis of mantle cell lymphoma with the 2014 diagnosis of non-Hodgkin lymphoma. Start with Rule M1. The first rule that applies is Rule M15, which instructs you to use the multiple primaries calculator. Enter 9673/3 and then 9591/3 and then calculate. The result is same primary.

If at a later time one of the differential diagnoses is confirmed, apply the rules again.

 

 

 

 

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
20140056

MP/H--Bladder: Are 8130 and rule H12 correct for this case? Bladder with papillary urothelial carcinoma with squamous cell differentiation.

Rule H8 applies, code the histology with the numerically higher ICD-O-3 code which is papillary transitional cell carcinoma, 8130.

Based on the information provided, there is a single bladder tumor, papillary urothelial carcinoma with squamous cell differentiation. Urinary sites rule H12 does not apply because this is a single tumor, not multiple tumors. In the single tumor H rules, H3 does not apply as this rule does not include papillary transitional cell carcinoma. Rule H4 is papillary carcinoma or papillary transitional cell carcinoma and refers you to Table 1. Table 1 does not list papillary urothelial carcinoma with squamous cell differentiation because there is no ICD-O-3 code for this histology. Table 1 does list transitional cell carcinoma with squamous differentiation as code 8120, however, the papillary transitional cell carcinoma is the higher code, 8130. We will review this situation for 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
20140074

Surgery of Primary Site--Brain and CNS: What procedure code would be used for NeuroBlate Laser Interstitial Thermal Therapy? This procedure was used for a Glioblastoma of the brain.

If a pathologic specimen is not taken during this procedure, code in the surgery field using code 10 (Local tumor destruction, NOS). If specimen is sent to pathology, code 90, surgery, NOS. We will request this procedure be included in future treatment field coding documentation.

Our research notes that this procedure, also known as LITT (Laser Interstitial Thermal Therapy), is a surgical treatment. Lasers transmit heat to coagulate or destroy the brain tumors from the inside out.

2014