Report Produced: 10/03/2022 08:20 AM
|Report||Question ID||Question (Ascending)||Discussion||Answer|
|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.|
|20061091||Reportability--Ovary: Is an "aggressive adult granulosa cell tumor with one of two lymph nodes positive for metastatic granulosa cell tumor" considered reportable?||Malignant granulosa cell tumor is reportable. The case described above is malignant as proven by metastasis to the lymph node.|
|20110045||Reportability--Ovary: Is immature teratoma of the ovary reportable if a subsequent comment states that "the teratoma shows immature neuroepithelium, but no malignant elements"?||There is conflicting information for this case. The final diagnosis conflicts with the comment. Go back and check with the physician to clarify his/her intent. If no further information can be obtained, the final diagnosis is preferred over the comment. This case is reportable based on the final diagnosis: "immature teratoma."|
|20120063||Reportability--Pancreas: Are neuroendocrine "tumors" reportable and are they synonymous with neuroendocrine "carcinoma"? See Discussion.||Example: Pancreatic mass that probably represents a neuroendocrine tumor is staged as cT2N0M0.||
According to the World Health Organization (WHO) pancreatic neuroendocrine tumors (NET) are malignant. They are reportable.
For pancreas primaries, code NET, G1 (well differentiated) to 8240/3; NET G2 (moderately differentiated) to 8249/3; and nonfunctional NET, GI or G2 to 8150/3.
The histology code for neuroendocrine carcinoma (NEC) is 8246/3, large cell NEC is 8013/3 and small cell NEC is 8041/3.
|20110012||Reportability--Sarcoma: Is "atypical lipomatous tumor/well-differentiated liposarcoma" reportable? See Discussion.||
The final diagnosis for a soft tissue excision is, "atypical lipomatous tumor/well-differentiated liposarcoma". The Comment section states, "Atypical lipomatous tumor/well differentiated liposarcoma has a significant risk for local recurrence, but no metastatic potential."
Per the 2010 SEER Manual, page 3, example 4: The pathologist makes the final decision about the behavior for a particular case. In this case, the pathologist uses both a reportable and a non-reportable term in the final diagnosis and in the comment section of the pathology report. Does the pathologist's comment impact the behavior and reportability of this tumor?
|For cases diagnosed 1/1/2014 and later: Atypical lipomatous tumor (8850/1) is not reportable. If the pathologist uses the term "well-differentiated liposarcoma" (8851/3) report the case. Use of this terminology indicates a less favorable prognosis.|
|20091013||Reportability--Skin: Is a "basal cell carcinoma of the skin of the lip with focal skin appendage differentiation" considered reportable?||
The histology code for basal cell carcinoma with skin appendage differentiation is 8098/3. Basal cell carcinomas (8090-8110) are not reportable to SEER. Skin appendage tumors are not reportable to SEER unless stated to be carcinoma or stated to be malignant.
According to our pathologist consultant, basal cell carcinoma with focal skin appendage differentiation is basal cell carcinoma which exhibits adnexal (appendage) features, but it is still considered basal cell carcinoma.
The case example above is not reportable to SEER.
|20051142||Reportability--Skin: Is a non-small cell carcinoma [8046/3] of the skin considered SEER reportable?||Non-genital skin primaries with a histology code equal to or less than 8110 are not reportable to SEER; therefore, the combination of C44_ and 8046/3 is not reportable.|
|20061023||Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses?||No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3.|