Report | Question ID | Question | Discussion | Answer | Year |
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20170051 | Reportability--Liver: Is intraductal papillary mucinous neoplasm (IPMN) of the liver a reportable diagnosis? See Discussion. |
Pathology shows: Right liver lobe, partial hepatectomy " intraductal papillary neoplasm with high grade dysplasia. |
Intraductal papillary mucinous neoplasm (IPMN) of the liver with high grade dysplasia is reportable. While most IPMNs arise from the pancreas, there exists a subset of IPMN of the biliary tract (BT-IPMN). Code as 8453/2. For more details, see the Reportability section of the SEER manual, https://seer.cancer.gov/manuals/2016/SPCSM_2016_maindoc.pdf |
2017 |
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20170024 | Reportability/Histology--Colon: Is tubular adenoma with high grade dysplasia and focal invasion from a pathology report of a colon biopsy reportable?; if so, what is the histology code? |
Tubular adenoma with high grade dysplasia and focal invasion is reportable. Assign the histology code and behavior as 8210/3 (Adenocarcinoma in tubular adenoma). NAACCR Guidelines for ICD-O-3 Implementation discuss the term high grade dysplasia (without invasion). High grade dysplasia and related terms are under review and study for consideration as a reportable neoplasm. Registries should check with their state reporting legislation to see if included in the reporting requirements. |
2017 | |
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20170011 | MP/H Rules/Multiple primaries--Breast: Can we accession two breast primaries when imaging is "suspicious for malignancy" on both breasts but only one biopsy is taken and is histologically confirmed, and assume bilateral complete response to neoadjuvant chemotherapy with bilateral mastectomies negative for residual cancer? See Discussion. |
The patient is diagnosed by bilateral mammograms suspicious for malignancy in both breasts. A biopsy is done on one breast and is positive. The physician states that he will not biopsy the contralateral breast, as the patient has consented to bilateral mastectomy. The patient receives neoadjuvant chemo, follow by bilateral mastectomies. Both breasts are negative for residual cancer, stated as a complete response. Based on "suspicious for malignancy" can we accession two primaries and assume bilateral complete response? |
Accession two breast primaries, one right and one left, rule M7. "Suspicious" is reportable ambiguous terminology. |
2017 |
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20170008 | MP/H Rules/Histology--Colon: Is the code for invasive adenocarcinoma in a serrated adenoma 8213/3? The NAACCR Guidelines for ICD-O-3 Update Implementation, effective 1/1/14, provides new terms including 8213/0 for sessile serrated adenoma/sessile serrated polyp and 8213/3 for serrated adenocarcinoma. This would cause Site/Type and Histology overrides to be set. Coding 8210/3 would allow the case to be reported without overrides. See Discussion. |
Pathology report 1/13/15, Histology - Transverse colon resection pathology = Invasive moderately differentiated adenocarcinoma. The invasive adenocarcinoma arises in a sessile serrated adenoma. |
Assign 8213/3 to invasive adenocarcinoma arising in a sessile serrated adenoma. The instruction in SINQ 20120089 is still valid. The 2014 ICD-O-3 Update does not change this SINQ answer. |
2017 |
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20170004 | MP/H Ruels/Histology--Kidney/renal pelvis: How is MiT family translocation renal cell carcinoma (RCC) with Xp11 translocation coded? See Discussion. |
Pathology states: Translocation renal cell carcinoma. Comment Tumor morphology and IHC profile consistent with MiT family translocation RCC with Xp11 translocation. |
Assign 8312/3 to MiT family translocation renal cell carcinoma (RCC) with Xp11 translocation. The recent WHO 4th Ed Tumors of the Urinary System has proposed a new ICD-O-3 code for MiT family translocation RCC, however the implementation of this new code has not yet been approved by the standard setters (SEER, CoC, CDC, NAACCR). Until it is approved, code histology to renal cell carcinoma (8312/3). |
2017 |
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20170031 | MP/H Rules/Multiple primaries--Penis: How many primaries should be reported for a diagnosis of invasive squamous cell carcinoma (SCC) of the penis in 6/2011, treated with excision and fulguration followed by 10/2014 penile lesion found to be SCC with basaloid features focally highly suspicious for invasion? Clinically, the 2014 tumor is stated to be in situ and recurrent penile cancer and follow-up in 2/2015 indicates there was no evidence of tumor following treatment. Subsequently, in 3/2016 the patient has another penile lesion biopsy showing SCC in situ suspicious for invasion, clinically stated to be recurrent. See Discussion. |
At the central registry, we have accessioned this scenario as three primaries per Multiple Primaries/Histology (MP/H) Rule M10 (diagnosed more than 1 year apart), as the patient was stated to be disease free between each occurrence. However, the diagnosing/treating facility is not reporting these cases due to clinical statements of recurrent disease. This is an example of a case type identified on casefinding audits conducted by our central registry in which we have learned SEER's expectation of MP/H rule application does not match hospital reporting. Can the 2018 version of the MP/H rules more clearly address how this type of clinically recurrent (multiple times) case should be handled? |
Accession three tumors as the tumors were each diagnosed more than one year apart according to the MP/H Rule M10 for Other Sites. And, as you have noted, the patient was free of disease after each diagnosis. The MP/H rules have very clear instructions regarding the word "recurrence." See page 10, specifically A.7., https://seer.cancer.gov/tools/mphrules/2007_mphrules_manual_08242012.pdf SEER will evaluate the MP/H rules in the upcoming revision. |
2017 |
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20170070 | Primary Site/Histology--Urinary: Is a urethral lesion showing intraductal carcinoma of the prostate reportable? What is the primary site and histology code? See discussion. |
Pathology report diagnosis: Urethral lesion: Intraductal carcinoma of the prostate, see microscopic. Clinical Information: Urethral Lesion/Hematura. Microscopic Description: The biopsy shows dilated ductal structures filled with anaplastic epithelium showing areas of comedo-type necrosis. The tumor cells have enlarged nuclei prominent nucleoli and mitoses are identified. Surrounding benign prostatic tissue is also present. Immunostains show that the tumor cells stain for PSA, PSAP, P504s but are negative for GATA-3. The other components of the PIN 4 stain CK5/14 and P63 stain the basal cells surrounding the tumor confirming the intraductal nature of the process. Intraductal carcinoma should not be confused with high grade PIN as the former is usually associated with high grade invasive tumor. Is this C619 and 8500/2? |
The primary site is prostate, C619, and the histology is intraductal carcinoma, 8500/2. Further workup on this case is likely. If more information is received, review this case and update if needed. |
2017 |
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20170052 | MP/H Rules/Histology--Bladder: Is urothelial carcinoma, high-grade, predominantly solid type, coded as 8120/3 or 8230/3? See Discussion. |
Urinary bladder: Invasive urothelial carcinoma, high-grade, 4.5cm, predominantly solid type, arising in background of carcinoma in-situ, carcinoma grossly extends into perivesical adipose tissue; lymph-vascular invasion is seen. |
Assign histology code 8120/3, urothelial carcinoma, NOS. Solid type is not a recognized variant of urothelial tumors and likely represents the appearance of the urothelial cells within the tumor and not a specific histologic type. |
2017 |
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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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20170026 | Multiple Primaries/Histology Rules/Multiple primaries--Kidney, renal pelvis: Are tumors diagnosed more than three years apart multiple primaries according to Rule M7 in a case with metastasis? See Discussion. |
5/27/02 Transurethral resection of bladder tumor (TURBT)--papillary transitional cell carcinoma, +lamina propria, no muscle invasion. All urine cytologies in 2011 and 2012 (only follow up received) show no malignancy. 3/11/15 Lung fine needle aspirate--poorly differentiated carcinoma consistent with urothelial carcinoma. 4/30/15 Renal pelvis biopsy--low grade papillary urothelial carcinoma, no lamina propria invasion, no muscularis propria invasion. |
Rule M7 applies. Abstract the bladder diagnosis and the renal pelvis diagnosis as separate primaries. The lung diagnosis is metastatic. The MP/H rules do not apply to metastatic tumors. |
2017 |