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Report Produced: 01/26/2023 20:22 PM

Report Question ID Question (Ascending) Discussion Answer
20081076 Reportability--Lung: Is carcinoid tumorlet of the lung a reportable disease? See Discussion. The literature on this is rather ambiguous as to whether these tumorlets (defined as <0.5 cm) are benign, such as atypical hyperplasia, or actual carcinoid tumors. Carcinoid tumorlets are not reportable. The histology can be similar to typical carcinoids; however, they are <5 mm in diameter and are benign/nonreportable.
20051067 Reportability--Lung: Is sclerosing hemangioma of the lung with multiple regional lymph nodes metastases considered reportable? No, it is not reportable. According to the WHO Classification of Lung Tumours, sclerosing hemangioma "behaves in a clinically benign fashion...Reported cases with hilar or mediastinal lymph node involvement do not have a worse prognosis."
20061097 Reportability--Lymphoma: Is a lymphoma diagnosed on a bone marrow biopsy considered reportable if the cytogenetics evaluation performed does not confirm the malignancy? See Discussion.

Bone marrow Bx: Marginal zone lymphoma/leukemia. The morphology of the lymphoma/leukemia cells and the immunophenotypic characteristics identified by flow cytometry are consistent with marginal zone lymphoma/leukemia.

Addendum Report: Cytogenetic evaluation revealed a 46,XY male karyotype. This is the normal male chromosome karyotype. Based on the limits of this methodology, no evidence of hematologic malignancy was observed in this specimen.

For cases diagnosed prior to 1/1/2010:

Yes, this case is reportable. The cytogenetic evaluation cited in the addendum report does not disprove the bone marrow biopsy diagnosis.

For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

20110040 Reportability--Melanoma: Is a pathology report with a final diagnosis stating only non-reportable terms, followed by a re-excision pathology report that indicates "no residual melanoma" considered reportable? See Discussion. Is a case reportable if the final diagnosis on an initial pathology report states a non-reportable term (e.g., evolving melanoma, early/evolving melanoma or melanocytic nevus) and followed by a subsequent re-excision pathology report stating there is "No residual melanoma"? There is no mention in the clinical history on the subsequent pathology report that the diagnosis was thought to be melanoma following the first procedure. The first mention of the reportable term was in the final diagnosis of the subsequent pathology report that stated "no residual melanoma."

No. This case is not reportable based on the information provided. "No residual melanoma" is not diagnostic of a reportable neoplasm.

We recommend that you try to obtain more information from the clinician/pathologist for this case due to the poor documentation. Check for any additional resection performed.

20071012 Reportability--Melanoma: Is a skin excision final diagnosis of "melanocytic tumor with uncertain malignant potential" reportable if the path COMMENT states the initial shave biopsy diagnosis was "melanocytic tumor with uncertain malignant potential [minimal deviation melanoma]"? See Discussion.


Comment: The prior outside biopsy report indicates that the lesion was a melanocytic tumor of uncertain malignant potential (minimal deviation melanoma) measuring at least 2.5 mm in depth. There was apparently no in situ component. Special stains performed here are similar, with positive reactivity for Melan A and S-100. The cells are atypical, but there are reactive changes, making it impossible to accurately assess the true nature of the lesion in this biopsy. If this is a minimal deviation melanoma, it would be classified as a T3 (T3a since there is no description in the outside report of ulceration) lesion. The atypical melanocytes extend to a depth of 1.1 mm in this 2 mm deep biopsy, but are completely excised, both at the deep margin and at all of the peripheral margins (closest margin is superior, with clearance of 7 mm).

PATH FROM INITIAL BIOPSY: Diagnosis: Rt dorsal foot, shave biopsy: Melanocytic tumor of uncertain malignant potential (see comment). Tumor depth at least 2.5mm Deep margin involved. Comment: As a primary lesion, I would favor that this represents a melanocytic tumor with indeterminate biologic potential also known as minimal deviation melanoma. The lesion does extend to the deep margin and wider excision is recommended.

This case is not reportable. Based on the information provided, there is no definitive diagnosis of malignancy.
20061086 Reportability--Melanoma: Is an excisional biopsy of the skin with a diagnosis on the pathology report of "Tumoral melanosis" reportable by itself or must there be a pathologist note, such as "Note: Unless proven otherwise, tumoral melanosis should be considered as a regressed melanoma", in order for it to be considered reportable? See Discussion.

Skin, left upper back, exc Bx: Tumoral melanosis. Note: Unless proven otherwise, tumoral melanosis should be considered as a regressed melanoma.

If reportable, do we report a diagnosis of tumoral melanosis without a similar note?

Tumoral melanosis (TM) alone is not reportable. It is not listed in ICD-O-3. TM can be associated with a regressed melanoma, but it can also occur with other cutaneous tumors. The case is reportable if there is a diagnosis of melanoma.
20061051 Reportability--Melanoma: Is the final diagnosis for an excisional skin biopsy of "compound nevus with severe cytoarchitectural atypia and regression" considered 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.
20010166 Reportability--Myelodysplastic Syndrome: How we handle cases of myelodysplastic syndromes identified in 2001 casefinding documents that are determined to have an "unknown diagnosis" date after review of the patient's hospital medical record?

Myelodysplastic syndrome cases with unknown dates of diagnosis identified in pre-2001 casefinding documents should not be accessioned or considered SEER reportable.

For cases identified in 2001 casefinding documents, when the diagnosis date cannot be confirmed using the medical records typically accessed by the registrar or central registry staff, do not accession these cases or consider them SEER reportable. This default applies only to those cases identified in 2001 casefinding documents.

For cases identified in 2002 or later casefinding documents, the attending physician should be contacted and asked to clarify the diagnosis date for cases identified with unknown dates of diagnosis. Clarifying the diagnosis date is necessary to determine whether the case is reportable and whether it should be accessioned.

20120085 Reportability--Ovary: Are mature teratomas of the ovary reportable? See Discussion.

Per a NAACCR Webinar from February 2011 (Testis), "All adult (post-puberty) pure mature teratoma tumors are malignant and should be coded 9080/3.' Does this apply to ovarian cases? The medical record entries all seem to consider this a benign process.

Should this NAACCR Webinar info be applied specifically to testicular cases? Would this be a reportable case if the primary site were testis?

The patient also has a history of medullary carcinoma of the thyroid. SINQ 20100052 indicates a thyroid primary may present in an ovarian teratoma. Would this be reportable, or must there be mention of the histology other than, or in addition to, the mature teratoma?

Mature teratomas in the ovary are benign [9080/0].

For testis, mature teratoma in an adult is malignant (9080/3); however, mature teratoma in a child is benign (9080/0).

With regard to the thyroid issue, from the information above, the medullary carcinoma in the patient's thyroid is clearly a separate event. According to our expert pathologist consultant, "thyroid tissue is one of the many tissue types that may be seen in teratomas. When the teratoma has exclusively or predominantly thyroid tissue the term struma ovarii is used Adenoma or carcinoma of the thyroid type may be seen in this thyroid tissue. If medullary carcinoma were present in the thyroid tissue in the ovary/teratoma, there would be mention of it in the path report."

20100109 Reportability--Ovary: Does the ICD-O-3 term "stromal endometriosis" [8931/3] always imply a reportable malignant disease process if the pathologist also states there is "no evidence of carcinoma" in the same report? See Discussion.

ROS Final Diagnosis: LSO: Ovary with an endometriotic cyst (1.2 cm) and stromal endometriosis with multifocal papillary syncytial eosinophilic, clear cell and tubal metaplasia, no evidence of carcinoma.

COMMENT: There is extensive endometriosis involving the ovarian stroma and the ovarian surface. The ovarian stroma contains multiple cystic endometrial glands and surrounding endometrial type stroma with variable amounts of hemorrhage. There are non-cystic foci of endometriosis comprised of small, irregular glandular structures within the stroma. The lining of larger cyst/cysts is involved by a single layer of cuboidal to columnar cells with markedly eosinophilic cytoplasm in areas of serous (tubal) metaplasia and papillary projections suggestive of papillary syncytial metaplasia. Within these areas there is epithelial tufting and stratification, raising the consideration of proliferative/borderline change (which we cannot entirely exclude), however, given the background of endometriosis and morphologic similarity to papillary syncytial metaplasia in the endometrium, we favor that this is a non-neoplastic reactive change. There is no evidence of carcinoma.

This case is not reportable. The pathologist states that there is no evidence of carcinoma. The ICD-O-3 matrix system applies, giving the pathologist the final say on behavior.