ID Status Question Discussion Answer Last Updated
20091102 Final MP/H Rules/Histology--Thyroid: What is
the correct histology for these thyroid
tumors? In each case, the path report
reads, "Papillary sclerosing carcinoma."
In one case, the results are in CAP
protocol format and next to
'Encapsulation of tumor' it says 'No.'
In the other case, it is not in CAP
format, but the microscopic description
says, 'encapsulation of tumor - no.' Is
the correct code 8350?
Code 8350 [Nonencapsulated sclerosing
carcinoma] per MPH Other Site Rule H11.
The definition for 8350 in the
Morphology section of ICD-O-3 includes
nonencapsulated as well as diffuse
sclerosing papillary carcinoma. When
the pathologist states 'No' for
encapsulated, that means
nonencapsulated.
10/01/09
20091100 Final MP/H Rules/Histology--Melanoma: Path:
Melanoma in situ, lentiginous type, skin
rt lower leg. Is this the same as acral
lentiginous melanoma (8744)? To code to
8744, do we specifically have to see the
word "acral" lentiginous melanoma?
Please see discussion.
In researching this, acral lentiginous
melanoma is observed on the palms, soles
and under the nails.
Assign 8742/2 [lentigo maligna] to
"melanoma in situ, lentiginous
type." Acral lentiginous melanoma is
not the same as melanoma, lentiginous
type. "Acral lentiginous melanoma,"
8744, should be used only if the report
states acral lentiginous melanoma or
malignant melanoma, acral lentiginous
type.

Acral lentiginous melanoma
most often occurs on the soles of the
feet or the palms of the hands.

10/01/09
20091096 Final MP/H Rules/Multiple primaries--Breast:
When an in situ diagnosis is followed by
an invasive diagnosis in the same breast
1.5 years later, is it a new primary?
See discussion.
Pt had a core bx 1/07 that showed DCIS.
Pt refused resection, followed by chemo
and/or XRT. A year and a half later
(6/08) the pt returns for a MRM which
shows infiltrating duct ca and positive
LNS. The 6/08 information came in as
a Correction Record. The comment in the
Correction Record stated “Per MD, pt
didn’t see any urgency and delayed
surgery 1.5 year after diagnosis. The
patient did not have any rx in that time
period. Not specifically stated that pt
had progression – only info is that pt
had no adenopathy 1/07 and then 6/08 had
positive LNS. Is the 6/08 a new
primary?
Abstract the 6/08 invasive diagnosis as
a separate primary according to rule M8.
Rule M8 applies whether or not the
later diagnosis in this case is
progression of disease.
10/01/09
20091036 Final CS Mets at DX--Ovary: Regarding
carcinomatosis; is it always captured in
CS Mets? Can the term carcinomatosis be
used to describe peritoneal implants as
well? Please see discussion.
Path text: 1/18/06: CT guided biopsy of
abdominal mass & ant peritoneum nodule.
Extensive carcinomatosis affecting the
paracolic gutters, liver surface &
pelvis. 6 cm tumor mass was visibly
engulfing the small bowel & tube; poorly
differentiated adenoca, mullerian
derived, shows attributes of clear cell
ca, high grade (FIGO III), 2.5 cm size.
does not involve fallopian tube. R&L
abdominal wall & mesentery, mets
adenoca. CA 125= 17 OP TEXT: 1/18/06:
CT guided bx of abdominal mass & ant
peritoneum nodule. extensive
carcinomatosis affecting the paracolic
gutters, liver surface & pelvis. 6 cm
tumor mass was visibly engulfing the
small bowel 5/31/06: tumor debulking
with right salpingo-oophorectomy. Final
DX: Poorly differentiated adenoca,
clear cell type, rt ovary (FIGO III),
stage IV per MD
In the case of ovarian cancer, the term
carcinomatosis may refer to peritoneal
implants, especially when the implants
are numerous. It does not refer to
distant metastases in this
context. This issue has been forwarded
to the CS version 2 committee.
10/01/09