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Report Produced: 10/08/2026 09:18 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20120080 MP/H Rules/Multiple primaries--Kidney, renal pelvis/Bladder: How many primaries are accessioned if the patient was diagnosed with transitional cell carcinoma in situ of the renal pelvis in October 2006, TCC in situ of the bladder in July 2008 and TCC in situ of the ureter in November 2009?. See Discussion. Per MP/H rule M8, the TCC in situ of the bladder diagnosed in July 2008 is the same primary as the TCC in situ of the renal pelvis diagnosed in October 2006. Should the new TCC in situ of the ureter diagnosed in November 2009 be a new primary per rule M7 because the renal pelvis TCC in situ was diagnosed in 2006? Or does the 3 year time frame for rule M7 start from the date of the last recurrence (July 2008)?

Abstract two primaries for this scenario per Rule M7. The first primary is the renal pelvis in Oct. 2006; the second primary is the ureter in Nov. 2009. The bladder tumor in July 2008 is not a new primary per Rule M8.

Compare the diagnosis date of the current (most recent) tumor to the diagnosis date of the original tumor. This applies even if the patient had six occurrences in-between these dates; you still compare the current tumor to the diagnosis date of the original tumor and ignore recurrences in this process.

See slide 6 of the Beyond the Basics presentation,

http://www.seer.cancer.gov/tools/mphrules/training_adv/SEER_MPH_Gen_Instruc_06152007.pdf.

Kidney, renal pelvis N/A 2012
20160045

Neoadjuvant treatment/Grade--Prostate: How should the grade/differentiation field be coded when hormone therapy is given prior to radiation for metastatic prostate cancer? Is hormone treatment "neoadjuvant treatment" in this situation? Per NCCN guidelines, neoadjuvant hormone therapy is strongly discouraged outside of a clinical trial for localized disease. However for metastatic disease, hormone is recommended (gold standard). See discussion.

8/1/15 CT Exam showed enlarged prostate and left seminal vesicle with multiple enlarged pelvic LNs. Findings: suspicious for prostate cancer with invasion of seminal vesicle. Bone scan findings: positive bone mets in multiple sites. PSA 169.0 (elevated). Patient was started on casodex 8/12/15. A prostate biopsy was performed on 9/16/15 to confirm diagnosis, adenocarcinoma Gleason 4+5. Patient's treatment continued with radiation to bone.

For cases diagnosed prior to 2018

Code the grade/differentiation field from the biopsy for this situation. According to experts consulted, hormone therapy does not alter the grade in this case and grade should be coded based on information after hormone therapy when that is the only grade information available.

 Prostate N/A 2016
20120095 MP/H Rules/Multiple primaries--Breast: How many primaries are accessioned if a patient is diagnosed with inflammatory carcinoma of the left breast, (ductal with apocrine features type on biopsy), and an incidental lobular carcinoma in the right breast? See Discussion. A 1.2 cm lobular carcinoma was incidentally discovered during the work-up of the patient's left breast that was inflammatory carcinoma. The lobular carcinoma on the right was localized without any skin involvement. Rule M6 indicates inflammatory breast carcinoma in either breast is a single primary. Does rule M6 apply when the patient has inflammatory carcinoma in one breast and a separate lobular carcinoma in the other?

For cases diagnosed 2007 or later, accession two primaries, ductal with apocrine features in the left breast and lobular carcinoma in the right breast.

The steps used to arrive at this decision are:

Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Breast MP rules because site specific rules exist for this primary.

Start at the MULTIPLE TUMORS module, rule M4. The rules are intended to be reviewed in consecutive order within a module. The patient has tumors in both the right and left breasts.

Rule M6 does not apply because inflammatory carcinoma involves only the left breast and the patient has a different histology in the right breast and there is no mention of inflammatory carcinoma in that breast. In this situation continue to the next applicable rule.

Breast N/A 2012
20031145 EOD-Extension--Head & Neck: Is this field coded 10 [Invasive tumor confined to one of the following subsites: interior wall, one lateral wall, posterior wall] or 30 [Localized, NOS] for tonsillar primary when there is no mention of involvement of surrounding structures? See Description. Site is stated to be "left tonsil" and was coded to site C099. "The lesion is admixed in tonsillar tissue." No surrounding structures are stated to be involved. Is it logical to assume that since code C099 includes the palantine tonsils and the palatine tonsils are on the lateral wall and since no other areas are stated to be involved that extension code 10 [confined to one lateral wall] would be more appropriate than code 30 [localized NOS]? For cases diagnosed 1998-2003: Code EOD-extension for the case example to 10 [Invasive tumor confined to one of the following subsites: anterior wall, one lateral wall, posterior wall]. The tonsil lies in a pocket on the wall (tonsillar fossa), so you know it is confined to the wall. Head & Neck N/A 2003
20010144 EOD-Extension--Cervix: How do you code tumor extension described as "the in situ lesion extends from the cervix to the mucosa of the vagina"? See discussion. Example: Cone biopsy of cervix and vaginal vault both show ca in situ. The op report stated: "lesion extending from the left lateral portion of the cervix onto the left lateral portion of the vagina." The pathologist stated it "appeared to be an in situ lesion extending from the cervix to the mucosa of the vagina."

For cases diagnosed 1998-2003:

Code the Primary Site to C53.9 [Cervix uteri] and the EOD-Extension filed to 00 [in situ]. In situ is a measurement of invasion. Extension of the cervical in situ carcinoma via the mucosa to the vagina does not affect the EOD extension code.

 Cervix Uteri N/A 2001
20130005 Reportability--Brain and CNS: Are spinal schwannomas and neurofibromas reportable or non-reportable? The most accurate and most current instruction is to report these spinal tumors when they arise within the spinal dura or spinal nerve roots, or when they are stated to be "intradural" or "of the nerve root." Do not report these tumors when they arise in the peripheral nerves. The peripheral nerves are the portion of nerve extending beyond the spinal dura. Brain and CNS N/A 2013
20031181

EOD-Extension--Kaposi Sarcoma: Is a "markedly enlarged spleen" involvement for cases of Kaposi Sarcoma?

For cases diagnosed 1998-2003: No. Splenomegaly is not synonymous with "extension to" or "involvement of" the spleen in Kaposi's sarcoma. Look for a definite statement of Kaposi's lesion(s) involving the spleen.

 N/A N/A 2003
20130022

Reportability--Melanoma: Is "early" melanoma reportable? See Discussion.

Because "evolving" melanoma was never reportable, this issue only relates to "early" melanoma.

For cases diagnosed 2018 to 2020, early or evolving melanoma is not reportable.

Evolving melanoma (borderline evolving melanoma): Evolving melanoma are tumors of uncertain biologic behavior. Histological changes of borderline evolving melanoma are too subtle for a definitive diagnosis of melanoma in situ. The tumors may be described as "proliferation of atypical melanocytes confined to epidermal and adnexal epithelium," "atypical intraepidermal melanocytic proliferation, "atypical intraepidermal melanocytic hyperplasia"; or "severe melanocytic dysplasia." Not reportable.

Melanoma Solid Tumor Rules, 2018, page 3, https://seer.cancer.gov/tools/solidtumor/Melanoma_STM.pdf

 Melanoma N/A 2013
20140004 Grade--Liver: How should grade be coded for a liver lesion treated with radio frequency ablation (RFA) followed by a transplant showing moderately differentiated hepatocellular carcinoma? See discussion. The SEER Manual emphasizes the importance of coding grade only prior to neoadjuvant treatment as systemic treatment and radiation can alter a tumor's grade. This patient did not have neoadjuvant chemotherapy or radiation, but did undergo a prior surgical procedure (RFA) in an attempt to destroy tumor tissue. The subsequent transplant showed residual moderately differentiated HCC. For this case, record the grade specified even though it is after RFA. RFA is not systemic or radiation treatment and should not alter the grade. N/A N/A 2014
20051013 Reportability/In Situ--Prostate: Was there a time period when PIN III was reportable to SEER? Per the 2004 SEER Manual, page 2, Reportable Diagnoses, Exceptions, 1.b.iii "Prostatic intraepithelial neoplasia (PIN III) of the prostate (C619). (Collection stopped effective with cases diagnosed 1/1/2001 and later.)" Prostate N/A 2005