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Report Produced: 02/17/2026 06:02 AM

Report Question ID Question Discussion Answer Year
20140020

Reportability--Breast: Is ADH/DCIS reportable?

Final Dx for left Breast biopsy: Atypical epithelial proliferation (ADH/DCIS). Comment: Sections show small focus of atypical epithelial proliferation with features of atypical duct hyperplasia/low grade duct carcinoma in-situ.

 ADH/DCIS is reportable. DCIS (duct carcinoma in situ) is a reportable neoplasm. When DCIS is stated as the final diagnosis, report the case. 2014
20140002 Reportability--Appendix: Is a pathologic final diagnosis of an appendix with "well-differentiated neuroendocrine tumor (carcinoid)" reportable? See discussion. SINQ 20130027 states that "well-differentiated neuroendocrine tumor" of the appendix is reportable (8240/3) while "carcinoid" tumors of the appendix are not reportable (8240/1). Please explain the difference between "well-differentiated neuroendocrine tumor" of the appendix and a "carcinoid" of the appendix.

Well-differentiated neuroendocrine tumor of the appendix is reportable. The difference is terminology. "Carcinoid" is listed in ICD-O-3 as a /1 for appendix making it non-reportable.

When both terms are used, ask for clarification from the pathologist. Failing that, accept the reportable terminology and report the case.

 2014
20140012 MP/H Rules/Histology--Breast: What is the correct histology code for this final diagnosis of a breast tumor: INVASIVE POORLY DIFFERENTIATED DUCTAL CARCINOMA WITH SQUAMOUS DIFFERENTIATION (METAPLASTIC FEATURES)?

Code the histology to 8575/3.

The instruction for coding duct and another non-duct histology not listed in Table 3 was inadverantly left out of the rules. The default is to code to the histology with the numerically higher ICD-O-3 code which is 8575/3.

 2014
20140082

MP/H Rules/Histology--Testis: How should histology be coded for a testicular teratoma with somatic type malignancy (adenocarcinoma)? See discussion.

11/8/2013 Rt orchiectomy: teratoma with somatic type malignancy (adenocarcinoma).

5/2/2014 Abdominal mass excision: metastatic teratoma involving matted lymph nodes. Patient age at diagnosis is 31.

Per web search, a teratoma with somatic type malignancy is a rare type of tumor. Should the histology be coded to 8140/3? This seems to conflict with SINQ 20120085, which indicates a testicular mature teratoma in an adult is malignant, and in this example, it was also the portion of tumor that metastasized.

Assign code 9084/3, listed in ICDO as teratoma with malignant transformation.

Our expert pathologist consultant states that this is a very rare situation. The non-germ cell components are believed to arise out of the teratoma portions, and are seen in only of few percent of teratomas. They are given the designation "teratoma with somatic type malignancies" (WHO).

2014
20140003 Surgery of Primary Site/Surgical Procedure of Other Sites--Endometrium: How are these fields coded for an endometrial primary when the patient undergoes a radical tumor cytoreduction including modified radical hysterectomy, BSO, omentectomy, resection of intra-abdominal and intrapelvic implants, and partial cystectomy? See discussion.

When other regional sites (besides the omentum) are removed with the primary site, how is Surgical Procedure of Other Site coded? There is no cytoreduction surgery code for endometrial primaries, and this patient does not appear to qualify for any of the specific pelvic exenteration codes.

Per SINQ 20091118, an omentectomy is not coded in the Surgical Procedure of Other Site field when it is performed with a hysterectomy.

 In general, record surgery of sites/organs not covered in the surgery of primary site codes under surgery of other site. For this case, code the partial cystectomy under surgery of other site. As you point out, the omentectomy is not recorded under surgery of other site when performed with a hysterectomy for an endometrial primary. 2014
20140035

Reportability/MP/H Rules/Histology: Is this kidney tumor diagnosis reportable? If so, what is the correct histology? See discussion.

Left radical nephrectomy: Tumor histologic type: Renal angiomyoadenomatous tumor (see Note). Note: The a clear cell papillary renal cell tumor and a renal angiomyoadenomatous tumor (""RAT"") (reval cell carcinoma with angioleiomyoma-like stroma). Although some authors consider RAT tumors to represent a pattern of clear cell papillary RCC we believe that this represents a dstinct entity. The combined findings ...confirm the diagnosis of renal angiomyoadenomatous (RAT) tumor. These tumors are also known as renal cell carcinoma within angioleiomyoma-like stroma. To date none of these tumors have developed metastases. Given the small number of reported cases we would consider these to have at worst a low malignant potential.

According to our expert pathologist adviser, renal angiomyoadenomatous tumor ("RAT") is not reportable. He states "l would be reluctant to consider the entity malignant. The authors of the papers describing it do not seem ready to call it malignant either. I agree with calling it LMP, or in this case uncertain malignant potential."

2014
20140038

MP/H Rules/Multiple Primaries--Urinary: How many primaries are there and which MP rules apply in this scenario? See discussion.

Patient has 2 tumors in the left ureter; one is transitional cell (8120) and one is papillary transitional cell (8130). Rule M6 says BLADDER tumors with any combination of the following histologies ... are a single primary. But this is not a bladder case. Rule M8 says urothelial tumors in 2 or more of the following sites are a single primary... but this is not in 2 or more sites. Rule M9 then says histologies different at the 1st, 2nd, or 3rd digit are separate primaries. That makes this 2 primaries, but I do not think this should be 2 primaries.

Rule M9 applies. Abstract 2 primaries.

We will evaluate this scenario for the next version of the multiple primary rules.

2014
20140064

Reportability--Testis: Is a mature teratoma of the testis reportable? See discussion.

Mature teratoma is listed as a benign neoplasm (9080/0) in the ICD-O-3. SINQ 20120085 references a NAACCR Webinar that indicated pure mature teratomas of the testis in adults are reportable. We are not aware of any further documentation of this change in reportability. When did mature teratomas of the testis for adults become reportable? What is the defined age range for "adult"? The original SINQ question above lists the 2012 SEER Manual as a Reference, however, no clarification or mention of this change in reportability was found in that manual.

For testis, mature teratoma in an adult (post-puberty) is reportable because it is malignant (9080/3); however, mature teratoma in a child is benign (9080/0). The 2011 NAACCR webinar introduced this concept and it was documented in the 2012 SINQ question. You may use 2011 or 2012 as the date of this change. The next edition of the SEER manual will include reportability examples.

2014
20140010 Multiple primaries--Heme & Lymphoid Neoplasms: Is this one primary or two? Follicular lymphoma grade 1 (9695/3) on 8/23/12 from an abdominal lymph node. On 1/6/14 an abdominal lymph node biopsy showed diffuse large b cell lymphoma arising from high grade follicle center cell lymphoma. Patient has been on observation.

1st primary, 8/23/12: Follicular lymphoma, grade 1 2nd primary, 1/6/14: Diffuse Large B Cell Lymphoma

Apply the multiple primary rules twice for this case. The 2012 diagnosis is follicular lymphoma. There are two histologies in 2014: diffuse large b cell lymphoma and follicle center cell lymphoma diagnosed at the same time in the same location. This is one primary per rule M4.

Then compare the 2012 diagnosis to the 2014 diagnosis.

Per the Hematopoietic Database, follicular lymphoma (all types) transforms to DLBCL. Per Rule M10, the DLBCL would be a second primary.

2014
20140017

Multiple Primaries--Heme & Lymphoid Neoplasms: 2012 path report for removal of an "axillary mass" which consists of 80% diffuse large B-cell lymphoma (DLBCL) and 20% follicular lymphoma. In the original manual, Module 6 instructed us to code as a single primary, DLBCL. However, the multiple primary calculator says each disease is a separate primary. When I looked them up in the data base, I did not get an option to review a current manual. Can you please advise?

Code as a single primary with histology Diffuse Large B-Cell Lymphoma.

In this case, there are two NHLs in the same location at the same time. Apply Rule M4, this is one primary. Per Note 5 under Rule M4, go to Rules PH11and PH15 to assign primary site and histology.

Rule PH11 states to code to the site of the origin (axillary mass) and to diffuse large b-cell lymphoma (9680/3) when DLBCL and any other non-Hodgkin lymphoma (follicular in this case) are present in the same location at the same time.

Using the multiple primaries calculator in this situation will give you two primaries, which is the wrong answer. Use the rules before using the calculator.

To get to the manual, go to the "Help me code for dx year." section. Choose 2010 or later and the most current manual will appear. We recommend that you save a copy of the PDF on your computer.

2014