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Report Produced: 04/17/2026 07:35 AM

Report Question ID Question Discussion Answer Year
20061051

Reportability--Melanoma: Is the final diagnosis for an excisional skin biopsy of "compound nevus with severe cytoarchitectural atypia and regression" reportable if a re-excision may be clinically indicated because there is an "overlap of morphology between malignant melanoma and nevi with severe atypia, and there's evidence of regression"?

Compound nevus with severe atypia is not reportable unless also stated to be malignant melanoma or melanoma in situ.

 2006
20160047

Reportability--Eye: Is conjunctival intraepithelial neoplasia (CIN III) from an excision of the left eye conjunctiva reportable?

Conjuctival intraepithelial neoplasia grade III (CIN III) is reportable. Intraepithelial neoplasia, grade III, is listed in ICD-O-3 as /2. It is reportable for sites other than skin.

2016
20240079

Reportability/Histology--Conjunctiva: Is low-grade conjunctival melanocytic intraepithelial lesion (LG-CMIL) with focal high-grade features of the conjunctiva (C690) reportable? If reportable, what histology should be assigned?

Additional comments in this pathology report state "The entire case was sent in consultation to an ophthalmic pathologist. [Pathologist] assigns a conjunctival melanocytic intraepithelial neoplasia (C-MIN) score of 2-3 due to the upward pagetoid migration of small, dendritic melanocytes. A C-MIN score of 2-3 is between low-grade conjunctival melanocytic intraepithelial lesion (LG-CMIL; C-MIN 2) and high-grade conjunctival intraepithelial lesion (HG-CMIL; C-MIN 3). The older terminology for this lesion would be primary acquired melanosis (PAM) with mild to focally moderate atypia."

This term does not appear in the SEER Program Coding and Staging Manual (SPCSM), Appendix E1 of the SPCSM, or Solid Tumor Rules (specifically rule H3) . 

Conjunctival melanocytic intraepithelial neoplasia (C-MIN) is reportable; therefore, low-grade conjunctival melanocytic intraepithelial lesion (LG-CMIL) with focal high-grade features of the conjunctiva (C690) is reportable, 8720/2.  We will add this to a future edition of the SEER manual.

 2024
20061136

Primary Site: What site code best reflects the final diagnosis of a metastatic "pancreatobiliary" adenocarcinoma to the liver? See Discussion.

CT showed multiple masses in the liver and lymphadenopathy in areas of gastrohepatic ligament, celiac axis, superior mesenteric and left periaortic regions. No mention of a mass in pancreas or common duct. When the term "pancreatobiliary" primary is stated in the final diagnosis, what site code should be used?

Contact the physician for clarification of the term "pancreatobiliary." If no further information can be obtained for this case, assign code C249 [Biliary tract, NOS] based on the CT findings for the specific case in this question.

When the primary is described as "pancreatobiliary" with NO FURTHER INFORMATION, assign C269.

 2006
20200087

Solid Tumor Rules (2018)/Histology--Thyroid: What is the correct histology code for a micropapillary thyroid carcinoma for cases diagnosed 1/1/2021 and later? See Discussion.

The 2021 ICD-O-3.2 Update includes papillary microcarcinoma (8341/3) as the preferred term for thyroid primaries (C739). However, there are multiple SINQ entries instructing registrars not to use code 8341/3 for diagnoses of micropapillary carcinoma of the thyroid (including SINQ 20071076, 20081127, 20110027, 20150023, and 20180008).

SINQ 20150023 specifically indicates: Per the WHO Tumors of Endocrine Organs, for thyroid primaries/cancer only, the term micropapillary does not refer to a specific histologic type. It means that the papillary portion of the tumor is minimal or occult (1 cm or less in diameter) and was found incidentally. WHO does not recognize the code 8341 and classifies papillary microcarcinoma of the thyroid as a variant of papillary thyroid carcinoma and codes histology to 8260. If the primary is thyroid and the pathology states papillary microcarcinoma or micropapillary carcinoma, code 8260 is correct.

Does this clarification apply to cases diagnosed 2021 and later? If WHO feels the term micropapillary still does not refer to a specific histologic type for the thyroid, why is 8341/3 listed as a preferred term for this morphology/site combination? For cases 2021 and later, should a diagnosis of Incidental papillary thyroid microcarcinoma (3 mm) in left lower pole, be coded as 8341/3 per the ICD-O-3.2, or as 8260/3 per clarification in multiple SINQ entries?

This question was prompted from preparing SEER*Educate coding exercises. We will use the answer as a reference in the rationales.

Continue to code micropapillary thyroid carcinoma to 8260/3 until instructed otherwise. This coding instruction is based on input from expert endocrine pathologists. This issue will be revisted based on the 4th Ed WHO Endocrine Tumors and updated if needed.

 2020
20200009

First course treatment/Surgery of Primary Site--Corpus uteri: Is an omentectomy performed with a hysterectomy for an endometrial primary site recorded under Surgery of Other Site? See Discussion.

Per SEER 20140003, an omentectomy is not recorded under Surgery of Other Site when performed with a hysterectomy for an endometrial primary. Is this still correct? CoC appears to have different guidelines stating in a forum that an omentectomy is coded in data item Surgical Procedure to Other Site. I would like to confirm SEER guidelines. Is this one of those unique situations that SEER and STORE differ? Our state follows SEER guidelines and would like to communicate the appropriate rules to our facilities.

Continue to record an omentectomy performed with a hysterectomy under Surgery of Primary Site and not as a separate procedure under Surgical Procedure of Other Site. The guidance In SINQ 2014003 and 20091118 is unchanged.

 2020
20200066

Reportability--Skin: Effective 2021, a cutaneous leiomyosarcoma is a related term for smooth muscle tumor, NOS (8897/1) in ICD-O-3.2. Currently, we have been capturing these as a C44_ (leiomyosarcoma, 8890/3) but the 2019 SEER inquiry states that atypical intradermal smooth muscle neoplasm (AISMN) was previously termed cutaneous leiomyosarcoma. This is not documented on the 2018 ICD-O-3 updates. Should this 2019 case be 8897/1 or 8890/3?

Cutaneous leiomyosarcoma is reportable for 2019. Code histology to leiomyosarcoma 8890/3.

As of cases diagnosed 1/1/2021, it is no longer reportable based on assignment to 8897/1 in ICD-O-3.2.

 2020
20010044

Reportability/Ambiguous Terminology/Date of Diagnosis: If a "suspicious" cytology is reportable only when a later positive biopsy or a physician's clinical impression of cancer supports the cytology findings, is the Date of Diagnosis field coded to the later confirmation date rather than to the date of the suspicious cytology? Is a suspicious "biopsy" handled the same way?

Cytology reported as "suspicious" is not reportable. If the physician confirms the suspicious cytology by making a clinical diagnosis of malignancy, the Date of Diagnosis field is coded to the date of the clinical diagnosis, which may or may not be same date the cytology was performed.

Without supporting clinical documentation, the case will remain non-reportable and will not be submitted to SEER. The supporting documentation can be a physician's statement that the patient has cancer, a scan or procedure that identifies cancer, or a positive biopsy.

Suspicious "biopsies" are reportable according to SEER's list of ambiguous terms. Suspicious "cytologies" without supporting clinical statements are not.

 2001
20130103 First course treatment--Heme & Lymphoid Neoplasms: Why isn't darbepoietin coded as treatment for hematopoietic diseases?

Darbepoietin is a synthetic form of erythropoietin. It stimulates erythropoiesis (increases red blood cell levels) and is used to treat anemia, commonly associated with chronic renal failure and cancer chemotherapy.

Darbepoietin is a support medication; it does not treat cancer. It is used to treat anemia caused by cancer directed chemotherapy treatments. It is not indicated for patients with myeloid cancers; cancers that originate in the bone marrow like leukemia.

Darbopoietin is an ancillary drug and is not coded as treatment.

2013
20021152 Primary Site: Can we assume the primary site for "chordoma" is soft tissue if the bone is not stated to be involved?

Default the coding of the Primary Site field for chordomas to the bone where the tumor began in the body if the primary site is not clearly stated to be soft tissue. Bone is often the primary site for chordomas.

Based on advice from pathologist consultants: This is one of those situations where we can be quite comfortable with a default, in this case to bone, not soft tissue. Chordoma is a tumor arising in the nucleus pulposis, presumably from remnants of notochord - thus its exclusive origin is in the sacrococcygeal region, spheno-occipital region, and vertebral bodies, otherwise known collectively as the axial skeleton. Any "chordoma" in soft tissue (with no relationship to axial skeleton) is probably a myxoid chondrosarcoma or parachordoma (extremely rare).

 2002