Report | Question ID | Question | Discussion | Answer | Year |
---|---|---|---|---|---|
|
20081120 | MP/H Rules--Sarcoma: How many primaries should be abstracted for chondrosarcoma of right toe in 2002, of right lower leg in 2006 and right tibia in 2007? See Discussion. | A patient had a myxoid chondrosarcoma of the right toe in 2002. This was amputated and staged as T2 - high grade. Patient had a recurrence in the lower right leg in 2006. At this time he had a below knee amputation. The tumor in 2006 was stated to be similar histologically to the 2002 tumor with pathologic comparison done. Then in 2007 the patient presents with pain in right knee and stump. CT says compatible with recurrent disease, but no copies of path sent. Patient then had an above knee amputation, with diagnosis of clinically recurrent chondrosarcoma of tibia. How many primaries should be abstracted? Is 2007 diagnosis a new primary? | For cases diagnosed 2007 or later: Abstract two primaries in this case, 2002 and 2007. The first primary was diagnosed in 2002. The 2006 diagnosis would not be a new primary according to the rules in effect at that time (2004 SEER manual, page 11, rule 5, exception 1). Use the current MP/H rules to compare the 2007 diagnosis to the 2002 diagnosis. Start with rule M3 and stop at rule M10. The 2007 diagnosis is a separate primary. |
2008 |
|
20081062 | MP/H Rules/Date of Diagnosis/Behavior--Brain and CNS: How many primaries would be reported when a December 2004 MRI shows a pineal region mass with the major differential consideration being pineocytoma; a November 2007 MRI that shows the mass has almost tripled in size; and the December 2007 resection final diagnosis is consistent with pineoblastoma? How would diagnosis date[s] and behavior code[s] be coded? See Discussion. | Dec. 2004 MRI of brain: Pineal region mass. The major differential consideration given patient's gender, age group, and imaging characteristics is pineocytoma. The differential includes pineoblastoma or germ cell line tumor. These are felt less likely. Nov. 2005 MRI brain: stable exam since last MRI. No change in size. Nov. 2007 MRI studies: pineal mass has almost tripled in size. Dec. 2007 Surgical resection of pineal tumor: High grade (WHO Grade IV) pineal parenchymal neoplasm consistent with pineoblastoma. |
For cases diagnosed 2007 or later: Abstract as separate primaries:
Complete two abstracts when a previously diagnosed non-malignant tumor transforms or progresses to a malignancy. Refer to the CDC/NPCR guidelines for Data Collection of Primary Central Nervous System Tumors, 2004. Malignant transformation is discussed on page 50. |
2008 |
|
20081099 | MPH Rules/Behavior--Breast: Would a positive right axillary node following DCIS of the right breast indicate the presence of a new primary? See Discussion. | How would you abstract the information from 2007? A patient with a strong family history of breast cancer had bilateral simple mastectomies in 2000, after a suspicious mammogram. Results showed DCIS in the rt breast; no malignancy in the left breast. Now in 2007, the patient has a right axillary lymph node removed - positive for carcinoma of breast origin. Comment says, "recurrent breast carcinoma in rt axillary node from patient's known history of DCIS." Is this a new primary? Is this a diagnosis date in 2007? Is the site C509 and laterality right side? | For cases diagnosed 2007 or later: A metastasis was diagnosed in 2007. The 2007 MP/H rules do not apply to metastases. Change the behavior code of the 2000 diagnosis. The breast cancer diagnosed in 2000 must have been invasive based on the metastasis in 2007. |
2008 |
|
20071074 | MP/H Rules/Multiple Primaries--Lung: How many primaries should be reported when an "adenocarcinoma" is discovered in one of several new nodules at the scar in a lung and it is less than a year after a wedge resection for a diagnosis of "bronchioalveolar adenocarcinoma" in the same lung? See Discussion. | In March 2006 patient diagnosed with bronchioalveolar adenocarcinoma [8250/3] and had wedge resection. In November 2006 a CT chest shows nodules at the scar suspicious for recurrence. In January, 2007, there was a biopsy of one of the nodules showing adenocarcinoma [8140/3]. Is this part of the original disease process diagnosed in March 2006 or should it be abstracted as a new primary based on 2007 MP/H rules (histology is different at the first 3 digits)? |
For cases diagnosed 2007 or later:
Try to obtain more information/clarification on the 2007 diagnosis -- for example, is it metastasis? Based only on the information provided for this case, the 2007 diagnosis is a separate primary. Use the 2007 MP/H rules to assess the 2007 diagnosis. Begin with rule M3 in the multiple tumors section. Stop at rule M11, multiple primaries. |
2007 |
|
20071103 | MP/H rules/Histology--Breast: How many primaries and what histologies are coded for a left breast when a bi-lumpectomy path reveals one tumor with a microscopic focus of mucinous adenocarcinoma and extensive DCIS and a second .9 cm mucinous adenocarcinoma with extensive DCIS, and the subsequent mastectomy reveals foci of residual DCIS and Paget's disease of the nipple? | For cases diagnosed 2007 or later:
There are two primaries. Primary 1: The two tumors described on the pathology report from the lumpectomy are a single primary using rule M13. Primary 2: Disregard the foci of residual DCIS. Paget disease of the nipple is a separate primary using rule M12.
Primary 1: invasive mucinous adenocarcinoma and extensive ductal carcinoma in situ: Code the histology as 8480/3 [mucinous adenocarcinoma] using rule H27. Primary 2: Paget disease of nipple: Code the histology as 8540/3 [Paget disease] using rule H14. |
2007 | |
|
20071123 | MP/H Rules/Reportability/Diagnostic Confirmation--Colon: Please clarify how to code diagnostic confirmation when there is no mention of a malignant polyp in the pathology report of a familial polyposis case given this statement: "Even if you have only one malignant polyp it is a single primary if there is a diagnosis of FAP. Even if there is no mention of a malignant polyp, if there is a diagnosis of FAP you will use this rule." |
For cases diagnosed 2007 or later:
In the very unlikely event of a FAP diagnosis with no malignancy, the case would not be reportable.
When FAP is diagnosed along with a colon malignancy, it is presumed that the malignancy originated in one of the numerous polyps, even if this is not explicitly stated. Use rule M3 for any colon malignancy (in a polyp, frank, or not stated) with a diagnosis of FAP and abstract as a single primary. |
2007 | |
|
20071128 | MP/H Rules--Urinary: How many primaries are abstracted when a patient has a May 2000 invasive papillary transitional cell carcinoma of the bladder, a November 2004 invasive papillary transitional cell carcinoma of the right ureter and a May 2007 urothelial carcinoma in situ of both the left and right ureters? | For cases diagnosed 2007 or later: Using the pre-2007 multiple primary rules, the PTCC of the bladder in 2000 and the invasive TCC of the right ureter in Nov. 2004 would have been abstracted as separate primaries.
Use the 2007 MP/H rules to evaluate the May 2007 diagnosis. Start with rule M3. Stop at rule M8. The May 2007 diagnosis is the same primary.
Rule M4 does not apply because of the 2000 bladder primary. A clarification will be added to M4 to stress that for the urinary rules, any urinary tumor up to the present point in time is counted when applying this rule. |
2007 | |
|
20020012 | MP/H Rules/Histology--Breast: What code is used to represent the histology "ductal carcinoma in situ and invasive lobular carcinoma"? See discussion. | Is the histology coded to the combination code of 8522/3 (ductal and lobular) or to the invasive component 8520/3 (lobular)? | For cases diagnosed 2007 or later:
Assuming ductal carcinoma in situ and invasive lobular carcinoma are present in a single tumor, code 8520/3 [Infiltrating lobular carcinoma, NOS]. Using the 2007 MP/H rules for breast, the single tumor invasive and in situ carcinoma module, start and stop at rule H9 and code the invasive histology. |
2002 |
|
20010026 | MP/H Rules/Histology--Prostate: What code is used to represent the histology "adenocarcinoma, microacinar type"? | For cases diagnosed 2007 or later:
Assign code 8140 [adenocarcinoma, NOS]. See the MP/H rules for Other Sites, histology coding rule H10. |
2001 | |
|
20071016 | MP/H Rules/Multiple Primaries--Bladder: The new multiple primary rule M7 states that tumors diagnosed more than three years apart are multiple primaries. Does this apply to in situ bladder tumors that occur more than three years apart and to an in situ tumor that occurs three years after an invasive tumor? | For cases diagnosed 2007 or later, use the MP/H rules in order. Rule M6 comes before rule M7.
M6 states that bladder tumors with certain histologies are a single primary. It is a single primary regardless of timing if there is any combination of:
Rule M7 applies to bladder tumors with histologies other than those listed above. If you have such a case, rule M7 applies to in-situ tumors and to an in situ three years after an invasive. |
2007 |