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Report Produced: 04/11/2026 06:06 AM

Report Question ID Question Discussion Answer Year
20071100 Type of Multiple Tumors--Colon: How is this field coded for a case in which the patient is found to have two in situ polyps and an adenocarcinoma arising in a polyp all in the same segment of the colon? See Discussion. Code 30 would not count the fact that these are polyps. Code 31 states "AND a frank adenocarcinoma." What would be the correct code? Assign code 30 [In situ and invasive] in this case. Code 31 does not apply here because frank adenocarcinoma is not present. 2007
20071099

MP/H rules/Histology--Lung: How is histology coded for a path diagnosis of "pleomorphic carcinoma with adenocarcinoma, squamous, clear cell and spindle components"? Please see discussion.

Path diagnosis of lung tumor is pleomorphic carcinoma, with adenocarcinoma, squamous, clear cell, and spindle cell components. Path comment states: "While the majority of tumor displays usual adenocarcinoma-type features, elsewhere the tumor shows varying differentiation, including squamous, clear cell and spindle cell differentiation. Therefore the tumor is best categorized as pleomorphic carcinoma."

This tumor is best described by a non-specific histology. However, the MP/H rules guide the abstractor to identify a more specific histology. If we work through the lung rules, would we end up using rule H7 and code the histology with the numerically highest ICD-O-3 code?

For cases diagnosed 2007 or later, assign histology code 8022 [pleomorphic carcinoma] based on the pathologist's assessment and rule H3. He/she reviewed all of the histologic components and rendered a final diagnosis of pleomorphic carcinoma.

"Components" is not a term indicative of a more specific histology. See note under rule H5.

 2007
20071098 Multiplicity Counter/Date of Multiple Tumors/CS Tumor Size--Lung: How are these fields to be coded when work-up of a malignancy spans a couple of months and reveals developing nodules? See Discussion. Example: Chest CT on 4-26-07 reveals 2.2 cm mass in lingula, left lung, consistent with lung malignancy. Biopsy on 5-18-07 shows non-small cell carcinoma. PET scan on 6-6-07 shows left upper lobe mass consistent with known non-small cell lung carcinoma. Second developing mass increasing in prominence since 4-07 in periphery of left upper lobe, approximately 3.6 cm which may represent intrapulmonary mets or second primary neoplasm. At least 3 additional intrapulmonary nodules have developed since 4-07, two in the left upper lobe and one in the right upper lobe, suspicious for mets.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Multiplicity Counter/Date of Multiple Tumors

Apply the multiple primary rules first and record the number of tumors determined to be a single primary in Multiplicity Counter. Record the corresponding date in Date of Multiple Tumors. These data items may be updated once if future tumors are determined to be the same primary as the initial diagnosis.

CS Tumor Size

Include information gathered through

  • completion of surgery(ies) in first course of treatment OR

  • all information available within four months of the date of diagnosis in the absence of disease progression

    • WHICHEVER IS LONGER.

    Metastasis known to have developed after the diagnosis was established should be excluded.

    		 2007
    		20071097 Multiplicity Counter--Thyroid: How is multiplicity counter to be coded for a thyroid cancer presenting as multiple foci? See Discussion. Thyroidectomy showed papillary thyroid carcinoma. Path diagnosis: tumor focality: multifocal. Path described 3 foci of tumor on each side. The main tumor mass in right thyroid was 1.5 cm. Smaller foci of tumor ranged in size from .1 cm to 1.0 cm. Per guidelines, "we still don't count foci as tumors for the purpose of these rules, even if there is more than one." The 1 cm tumor was probably macroscopic in size. Do we count it in the multiplicity counter? Do we count only the 1.5 cm main tumor mass?

    If the number of tumors is known, code the number in Multiplicity Counter. If foci are measured, include them in the multiplicity counter. If the only information available is "multiple foci" assign code 99.

    For the case above, code 06 in the multiplicity counter (3 tumors on each side).

    		 2007
    		20071096 Multiplicity Counter--Prostate: How is multiplicity counter to be coded for a clinically inapparent prostate cancer for which sextant needle biopsy cores on left and right sides are positive for adenocarcinoma? See Discussion.

    Prostate cancer typically presents as multifocal diffuse disease. The coding exercise in the MPH rules presentations coded prostate cancer as one tumor.

    Reference: SEER Training Web Casts - Other Sites Rules Practicum

    		 Code the number of tumors present if known. This information can be taken from any part of the record, including imaging and prostatectomy. If the only information available is "diffuse," or "multifocal," assign code 99. Do not assume there are multiple tumors just beacause there are multiple biopsies. When there is no information about the number of tumors, code Multiplicity Counter to 99 and Type of Multiple Tumors to 99. 2007
    		20071094 Multiple Primaries--Brain and CNS: How many primaries should be recorded in a patient with von Hippel Lindau disease that has a hemangioblastoma of the cerebellum in 2003 and a hemangioblastoma of the brainstem in 2007? A tumor of the cerebellum (C716) and a tumor of the brainstem (C717) are multiple primaries because the topography codes are different at the fourth character of site. 2007
    		20071093 Reportability--Brain and CNS: In addition to Schwannoma, are there additional types of benign tumors that arise in peripheral nerves along the spinal cord that are not reportable? See Discussion.

    Are neuroepitheliomatous neoplasms such as ganglioneuroma, gangliocytoma, ganglioglioma occurring along the spinal cord reportable? Are nerve sheath tumors such as neuroma occurring along the spinal cord reportable? Angioma?

    Reference: SINQ 20051071; Primary Central Nervous System Tumors, NPCR Training Materials 2004

    Reportability depends on the location of the tumor. Tumors in the following sites are reportable:

    • C700 - C709

  • C710 - C719

  • C720 - C729

  • C751 - C753

    • Benign and borderline tumors of the peripheral nerves (C47_), including peripheral nerves along the spinal cord, are not reportable.

    Please note: spinal schwannomas arising in the nerve root or spinal dura are reportable.

    		 2007
    		20071092 Reportability/Primary Site--Brain and CNS: Is a chondroma, NOS or a chondroblastoma, NOS that occurs in an intracranial site or along the spinal cord reportable? See Discussion.

    In ICD-O-3, chondroma and chondroblastoma are site-associated morphologies for bone. If a chondroma or a chondroblastoma occurs along the spinal cord, is this one of those situations where we can be quite comfortable with a default site to bone and not to spinal cord?

    Reference: ICD-O-3; Primary Central Nervous System Tumors, NPCR Training Materials 2004; SINQ 20021152

    Chondroma, NOS or chondroblastoma, NOS occuring in intracranial sites or along the spinal cord are not reportable.

    Chondroma, NOS and chonroblastoma, NOS are benign tumors of the bone itself, not the intracranial contents.

    		 2007
    		20071090 Multiplicity Counter/Type of Multiple Tumors--Breast: How are these data items coded for a single breast primary composed of both in situ and invasive disease when measurements are provided for both the invasive and in insitu components? See Discussion. Breast cancer, invasive duct carcinoma with DCIS, 1.3 cm, DCIS 3.7 cm. "The in situ carcinoma is very extensive in this lumpectomy. It is present contiguously from sides 1A through 1L sparing only the final 8 mm of medial margin. In situ and invasive carcinoma are prominently present along almost the entire superior margin." Is the mult counter 02 with Type of mult tumor 30, or one tumor? Because there are individual measurements for each of these tumors, code the multiplicity counter 02 [Two tumors present]. Code Type of Multiple Tumor as 30 [In situ and invasive]. 2007
    		20071089 CS Extension--Ovary: Are "non-invasive implants" identified per pathology coded differently than "invasive implants"?

    This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.No, non-invasive and invasive implants are not handled differently in collaborative staging for ovary.

    		 2007