Report | Question ID | Question | Discussion | Answer | Year |
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20120085 | Reportability--Ovary: Are mature teratomas of the ovary reportable? See Discussion. |
Per a NAACCR Webinar from February 2011 (Testis), "All adult (post-puberty) pure mature teratoma tumors are malignant and should be coded 9080/3.' Does this apply to ovarian cases? The medical record entries all seem to indicate this a benign process. Should this NAACCR Webinar info be applied specifically to testicular cases? Would this be a reportable case if the primary site were testis? The patient also has a history of medullary carcinoma of the thyroid. SINQ 20100052 indicates a thyroid primary may present in an ovarian teratoma. Would this be reportable, or must there be mention of the histology other than, or in addition to, the mature teratoma? |
Mature teratomas in the ovary are benign [9080/0]. For testis, mature teratoma in an adult is malignant (9080/3); however, mature teratoma in a child is benign (9080/0). With regard to the thyroid issue, from the information above, the medullary carcinoma in the patient's thyroid is clearly a separate event. According to our expert pathologist consultant, "thyroid tissue is one of the many tissue types that may be seen in teratomas. When the teratoma has exclusively or predominantly thyroid tissue the term struma ovarii is used Adenoma or carcinoma of the thyroid type may be seen in this thyroid tissue. If medullary carcinoma were present in the thyroid tissue in the ovary/teratoma, there would be mention of it in the path report." |
2012 |
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20170045 | Reportability--Brain and CNS: Is meningioangiomatosis reportable as meningiomatosis (9530/1) or angiomatous meningioma (9534/0)? See Discussion. |
Pathology report: Brain tumor, left side: Gliotic cortex and subcortical white matter with meningioangiomatosis (see Comment). Comment This specimen represents a meningioangiomatous lesion located in the leptomeninges that projects along the Virchow-Robin spaces into the underlying cortex. The surrounding brain parenchyma demonstrates reactive changes with astrogliosis and microgliosis. An intraparenchymal neoplasm is not seen. Meningioangiomatosis is a rare benign meningovascular hamartomatous condition and usually appears in young patients. |
Meningioangiomatosis is not reportable. It is a cortical lesion which may occur sporadically or in NF2 (neurofibromatosis type 2). It is not listed in ICD-O-3. |
2017 |
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20160011 | Reportability--Stomach: Are microcarcinoid tumors reportable? See discussion. |
SINQ 20081076 states carcinoid tumorlets of the lung are not reportable and are defined as being less than 5 mm in diameter and benign. Per the WHO Classification of Digestive Tumours, microcarcinoid tumors are precursor lesions/nodules measuring greater than 0.5 mm, but less than 5 mm (0.5 cm). Is the term microcarcinoid tumor equivalent to carcinoid tumorlet, and therefore not reportable? Or is a microcarcinoid tumor a reportable type of neuroendocrine tumor (NET)? |
Microcarcinoid and carcinoid tumors are reportable. The ICD-O-3 histology code is 8240/3. Microcarcinoid is a designation for neuroendocrine tumors of the stomach when they are less than 0.5 cm. in size. Neuroendocrine tumors of the stomach are designated carcinoid when they are 0.5 cm or larger.
The term microcarcinoid tumor is not equivalent to carcinoid tumorlet. |
2016 |
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20180050 | Reportability/Heme & Lymphoid Neoplasms: Is monoclonal B-cell lymphocytosis reportable? See Discussion. |
We noticed this term was added to the most recent version of the Heme Database (DB) as an alternate name for chronic lymphocytic leukemia/small lymphocytic lymphoma; however we do not recall being notified that this was a new reportable term for code 9823 and the term was not included in the 2018 ICD-O-3 Histology updates. The Definition in the Heme DB for Chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL) includes information that the term was added in the 2016 WHO revision, thus would be reportable back to 2016, is that correct? In addition, the Definition seems to be describing it as a precursor condition to CLL and may never actually evolve into CLL, so it is unclear if this term should really be reportable. Example: 09/08/2016 Onc Note: A/P: monoclonal B-cell lymphocytosis of undetermined significance (MBL): I reviewed with him the results of the bone marrow biopsy. Interestingly, there is no evidence of abnormal plasma cell population by flow cytometry and immunohistochemistry. Nevertheless, flow cytometry does demonstrate a very small population of abnormal and monoclonal B-cell lymphocyte population with immunophenotype consistent with CLL/SLL. Given the very low number of the abnormal B cells, this can be categorized as monoclonal B-cell lymphocytosis (MBL). I recommend surveillance visit in one year. 9/12/2017 Onc note: A/P: Monoclonal B-cell lymphocytosis of undetermined significance (MBL) and IgM MGUS. No symptoms concerning for active disease or progression. Explained that MBL is a very indolent process. Patients with CLL-phenotype MBL progress to CLL at a rate of ~1-2 percent per year. Follow-up in 1 year. Is this case reportable? |
Monoclonal B-cell lymphocytosis is not a reportable condition. This term will be removed from 9823/3 since it is a /1 (has it's own code). This will become much more clear once we get the new WHO Heme terms into the database. |
2018 |
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20150009 | Multiple Primaries/Behavior--Lung: When a patient has an invasive lung primary, how do in situ tumors of the lung affect the determination of multiple primaries? See discussion. |
How many primaries should be reported when a 12/19/14 RUL lung wedge resection shows: 2.0 cm invasive adenocarcinoma (8140/3) and an additional RUL wedge resection during the same procedure shows: multifocal adenocarcinoma in situ (bronchioloalveolar carcinoma), non-mucinous type (8252/2) size: 1 mm – 2 mm; followed by a 2/12/15 left upper lobectomy also showing Adenocarcinoma, invasive at several foci, with a prominent bronchioloalveolar (in situ) component….tumor focality: multifocal (10 cm mass, 6 cm mass and numerous smaller foci)? |
Most often when the invasive tumor and the in situ component are in the same lung and are the same histology, rule M12 (example 3) applies and this is a single primary. If the first wedge resection included part of the tumor and the in situ was not separate from the tumor, it is a single primary. We suspect that the margins were positive on the first wedge specimen which prompted the second wedge resection where the in situ was found. In addition, terminology for lung malignancies is undergoing change: what was called BAC (invasive) is now called adenocarcinoma in situ. |
2015 |
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20160037 | Reportability/MP/H Rules/Histology--Ovary: What is the histology code for an ovarian tumor described as a mucinous borderline tumor, intestinal type? |
Mucinous borderline tumor, intestinal type, of the ovary is not reportable. The behavior is /1. There is no applicable histology code for this histology when it ocurs in the ovary. |
2016 | |
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20110072 | Multiplicity Counter/Date Multiple Tumors--Bladder: How are these fields coded when multiple tumors were present at the time of diagnosis and another tumor diagnosed a year later is determined to be the same primary? See Discussion. | In November 2007, a nephroureterectomy showed an invasive TCC of the renal pelvis and a separate in situ TCC of the ureter. The Multiplicity Counter field is coded 02 and the Date Multiple Tumors is coded to November 2007. In December 2008, an in situ bladder tumor is found. Are the multiplicity fields to be updated to reflect the new bladder tumor? | Multiplicity Counter field was initially coded 02. Change the code to 03 because the subsequent, additional tumor was determined to be the same primary. Update the Multiplicity Counter field only once. If additional tumors are determined to be the same primary for this case, it is not necessary to update this field again.
Date of Multiple Tumors field was initially coded November 2007. Multiple tumors were present at the time of the initial diagnosis. Do not change the date of this field when additional tumors are subsequently diagnosed. This data item reflects the earliest date that multiple tumors were present. See example 2 under #3 on page 81 of the 2010 SEER manual. |
2011 |
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20081066 | Multiplicity Counter/Type of Multiple Tumors--Breast: How should these fields be coded when path shows a 1.2 cm infiltrating carcinoma with lobular features and several foci of infiltrating lobular carcinoma [7 foci described as multifocal], 1 large focus, and numerous foci of LCIS and CIS with lobular and ductal features? Should we count the foci or separate tumor nodules, ignore them, or code unknown values for these fields? See Discussion. | Scenario: 10/17/07: Right axilla soft tissue bx - infiltrating mammary ca with lobular features arising within apparent breast tissue present within axilla. Tumor size 1.2 cm. 11/3/07: Right breast, reexcision lumpectomy - Several foci of infiltrating lobular CA. (2) foci & (5) foci within specimen (multifocal). (1) large focus also present. No lymphovascular invasion identified. Numerous foci LCIS. Pleomorphic LCIS & CIS with lobular and ductal features. Margins free of invasion however margins diffusely involved with LCIS.
When do you count foci or separate tumor nodules, when do you ignore them, and when do you code unknown values for these fields? Coding instruction 3b states, "When the tumor is multifocal or multicentric and the foci of tumor are not measured, code as 99." Instruction 4b states, "Use code 01 when there is a single tumor with separate foci of tumor." Finally, instruction 6b states, "Use code 99 when the tumor is described as multifocal or multicentric and the number of tumors is not given," which seems to imply that if we know the number of tumors, we would code that number. |
Multiplicity Counter: Use instruction 4b. Since there is one measured tumor and the foci were not measured, code the multiplicity counter 01 [One tumor only]. Type of Multiple Tumors: Code Type of multiple tumors 00 [Single tumor]. |
2008 |
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20010166 | Reportability--Myelodysplastic Syndrome: How we handle cases of myelodysplastic syndromes identified in 2001 casefinding documents that are determined to have an "unknown diagnosis" date after review of the patient's hospital medical record? |
Myelodysplastic syndrome cases with unknown dates of diagnosis identified in pre-2001 casefinding documents should not be accessioned and are not SEER reportable. For cases identified in 2001 casefinding documents, when the diagnosis date cannot be confirmed using the medical records typically accessed by the registrar or central registry staff, do not accession these cases; they are not SEER reportable. This default applies only to those cases identified in 2001 casefinding documents. For cases identified in 2002 or later casefinding documents, the attending physician should be contacted and asked to clarify the diagnosis date for cases identified with unknown dates of diagnosis. Clarifying the diagnosis date is necessary to determine whether the case is reportable and whether it should be accessioned. |
2001 | |
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20180023 | Reportability/Behavior: Is myxoinflammatory fibroblastic sarcoma (MIFS) reportable for 2018? This histology is on the 2018 ICD-O-3 histology update list with a behavior code of /1. See discussion. |
This will be a tough one for registrars to recognize as non-reportable since the terminology contains sarcoma, so we just want to double check. |
Myxoinflammatory fibroblastic sarcoma (MIFS) (C49._), 8811/1, is not reportable for 2018 based on the 2018 ICD-O-3 New Codes, Behaviors, and Terms list. This is a new histology/behavior not previously listed in ICD-O-3. According to the WHO 4th Ed Tumors of Soft Tissue & Bone, this histology has been given a benign (/1) behavior; however, if the pathologist and/or physician state the tumor is malignant or metastatic, report the case and assign behavior code /3. |
2018 |