Solid tumor rules 2025 update

[bekeles]

Colon
Rule M3, update rule text to include new bullet “Referred to as polyps carpeting the bowel, small bowel, intestines, etc.”

Non-Malignant CNS

From AASR 41895: Can you please check on the logic for M7 (previously M6)? "Abstract a single primary when the patient has bilateral: Acoustic neuromas/ vestibular schwannomas 9560/0"
A user reported that in this scenario: "were diagnosed with acoustic neuroma 9560/0
One is a paired site (C72.4 or C72.5) and the other is not a paired site(C72.0 spinal cord)"
It is stopping at this rule and returning single. Lois confirmed that this should be multiple.
What is the current logic for this rule? I will ask Lois how we can change it to fix this.

“Angiocentric glioma 9431/1” row removed; (9431 added to 9421 row as a subtype/variant)
Row added: “Low Grade glioma 9380/1”
“Diffuse astrocytoma, MYB- or MYBL1altered 9421/1” row: Subtype/variant added: “Angiocentric glioma / Angiocentric neuroepithelial tumor/ Monomorphous angiocentric glioma 9431/1”
“Solitary fibrous tumor Grade 1 8815/1” row: behavior code /1 added to histology code
New M Rule M5: Abstract a single primary when a neoplasm is originally diagnosed as low-grade glioma and subsequently recurs in residual tumor with a more specific histology. (Glioma=9380/1; any other histology in table 6 is a more specific histology)
New M Rule M13: Abstract a single primary when separate, non-contiguous tumors are Glioma NOS and a subtype/variant of Glioma NOS. (Glioma=9380/1; any other histology in table 6 is a more specific histology)

Malignant CNS
“Meningeal melanoma 8720” row: Subtype/variant removed: “Meningeal Melanomatosis 8728”
“Sarcoma NOS 8800” row: Subtype/variants added:
“Myxoid pleomorphic liposarcoma 8859”
“Round cell sarcoma with EWSR1-non-ETS fusion 9366”
“Sarcoma with BCOR genetic alterations 9268”
“Solitary fibrous tumor grade 3 8815/3” row: “/3” added to histology code 8815

Breast
“Adenomyoepithelioma with carcinoma 8983” row: Subtype/variant added: “Epithelial-myoepithelial carcinoma 8562”
“Metaplastic carcinoma NOS or of no special type (NST) 8575” row: Code for “Low grade adenosquamous carcinoma” corrected from 8560 to 8570
Row added: “Neuroendocrine carcinoma NOS 8246/3” with subtype/variants:
“Carcinoma with neuroendocrine differentiation 8574/3”
“Large cell neuroendocrine carcinoma/large cell carcinoma 8013/3”
“Small cell neuroendocrine carcinoma/small cell carcinoma 8041/3”
Row added: “Neuroendocrine tumor NOS 8240/3” with subtype/variant 8249/3
Row deleted: “Small cell carcinoma 8041” and subtype/variants 8574/3 and 8246/3 (all moved to new 8246 NEC row)

Other Sites

Table 1: Paired Organs and Sites with Laterality: C413, C414 removed
Table 2: Mixed and Combination Codes: Row added: “Mixed acinar-ductal carcinoma 8552”
Table 5: Esophagus Histologies: Row added “Mucosal melanoma 8720/3”
Table 6: Stomach Histologies: Row added “Intestinal-type adenoma, high grade 8144/2”
Table 7: Small Intestine and Ampulla of Vater Histologies: Row added “Intestinal-type adenoma, high grade 8144/2”
Table 8: Anus Histologies: Row added: “Mucosal melanoma 8720/3”
Table 11: Pancreas Histologies: “Intraductal oncocytic papillary neoplasm 8455/2” row: “/2” added to 8455
Table 18: Vagina Histologies: Row added: “Mucosal melanoma 8720/3”
Table 19: Vulva Histologies:
Row added: “Mucosal melanoma 8720/3”
“Squamous cell carcinoma NOS 8070” row: Subtype/variants added:
“Differentiated vulvar intraepithelial neoplasm 8071/2; Squamous cell carcinoma keratinizing 8071/3”
“Squamous cell carcinoma, non-keratinizing 8072”
“Vulvar intraepithelial neoplasm grade 2/vulvar intraepithelial neoplasm grade 3 8077/2”
Table 22: Thymus Histologies
“Adenocarcinoma, NOS 8140” row:
“/3” behavior code added to subtype/variants 8144 and 8200
“/2” behavior code added to subtype/variant 8260
“Adenosquamous carcinoma 8560/3” row: “/3” behavior code added to histology
“Clear cell carcinoma 8310/3” row: “/3” behavior code added to histology
“Mucoepidermoid carcinoma 8430/3” row: “/3” behavior code added to histology
“Sarcomatoid carcinoma 8033/3” row: “/3” behavior code added to histology
“Squamous cell carcinoma NOS 8070” row: “/3” behavior code added to all subtype/variants
“Thymoma, NOS 8580/3” row: “/3” behavior code added to histology in column 1 and all subtype/variants
Table 23: Penis and Scrotum Histologies
C630 added to sites covered by table
Row added: “Mucosal melanoma 8720/3”
“Squamous cell carcinoma, NOS 8070” row: Subtype/variant added: “Warty-basaloid carcinoma/Warty carcinoma 8054 " (If you maintain the terms and not just the codes, then warty carcinoma was removed from 8051 and moved to 8054. if you don't care about the terms then don't worry about that)

Kidney
Row added: “Paraganglioma 8700/3”

Lung

If you maintain the terms… “Epithelioid hemangioendothelioma 9133” row: "hemangioepithelioma” corrected to “hemangioendothelioma”
Rule M5: Rule rewritten, logic should be updated too. Logic should be: If there is any of NET or NEC (NET/NEC=8246, 8045, 8041, 8240, 8249) AND there is NSCLC (NSCLC=8046, or any histology in tables 2 and 3 EXCEPT 8246, 8045, 8041, 8240, 8249, 8800, 9043, 9042, 9137, 8842, 9041, 9040)

Urinary
“Malignant melanoma 8720/3” row: Subtype/variants added:
“Mucosal lentiginous melanoma 8746/3”
“Nodular melanoma 8721/3”
Rows added:
“Mixed adenocarcinoma 8323/3”
“Mixed neuroendocrine-non-neuroendocrine carcinoma 8154/3”
“Paraganglioma 8693/3”
Rule M8 rewritten. This now applies to all urinary sites. Logic should be: Abstract multiple primaries when there is 8131/3 AND any of (8120 and all subtypes/variants except 8131); tumors can be in any combination of urinary sites C659, C669, C670-C679, C680-C689

Head and Neck

Table 1: Tumors of Nasal Cavity, Paranasal Sinuses and Skull base.
Rows added:
“HPV-related multiphenotypic sinonasal carcinoma 8483/3”
“SMARCB1-deficient sinonasal carcinoma 8044”
“Mucosal melanoma 8720” row: Subtype/variants added:
“Desmoplastic mucosal melanoma 8745/3”
“Mucosal lentiginous melanoma 8746/3”
“Nodular melanoma 8721/3”
“Squamous cell carcinoma 8070” row: Subtype/variants added:
“HPV-associated squamous cell carcinoma 8085”
“HPV-independent squamous cell carcinoma 8086”
Table 3: Tumors of Pyriform Sinus, Hypopharynx, Larynx, Trachea, and Parapharyngeal Space
“Chondrosarcoma 9220/3” row: Subtype/variants added:
“Clear cell chondrosarcoma 9242/3”
“Dedifferentiated chondrosarcoma 9243/3”
Table 4: Tumors of Oral Cavity and Mobile Tongue
Rows added:
“Adenosquamous carcinoma 8560”
“Granular cell tumor 9580”
“Mucosal melanoma 8720” row: (If you care about terms, Column 1 term updated from “Oral mucosal melanoma” to Mucosal melanoma). Subtype/variants added:
“Desmoplastic mucosal melanoma 8745/3”
“Mucosal lentiginous melanoma 8746/3”
“Nodular melanoma 8721/3”
“Squamous cell carcinoma 8070” row: Subtype/variants added:
“Basaloid squamous cell carcinoma 8083”
“Lymphoepithelial carcinoma 8082”
“Papillary squamous cell carcinoma 8052”
“Spindle cell squamous cell carcinoma 8074”

Table 6: Tumors of Salivary Glands
“Adenocarcinoma 8140” row: (If you care about terms, The term “Malignant dermal analogue tumor” removed from 8147).
Subtype/variants removed:
“Cribriform adenocarcinoma 8201"
“Large cell carcinoma NOS/large cell undifferentiated carcinoma 8012”
“Lobular carcinoma 8520”
“Mucinous cystadenocarcinoma 8470”
“Salivary duct carcinoma 8500” and all synonyms (moved to its own row)
“Undifferentiated carcinoma 8020” (moved to its own row)
Rows added:
“Polymorphous adenocarcinoma 8525”
“Salivary duct carcinoma 8500” along with subtype/variants:
“Micropapillary salivary duct carcinoma 8265/3”
“Mucin-rich salivary duct carcinoma 8481/3”
“Oncocytic salivary duct carcinoma 8290/3”
“Sarcomatoid salivary gland carcinoma 8033/3”
“Undifferentiated carcinoma 8020/3”

Table 7: Tumors of Odontogenic and Maxillofacial Bone (Mandible, Maxilla)
“Sarcoma NOS 8800/3” row: Subtype/variants added:
“Ameloblastic fibrosarcoma/ Ameloblastic fibrodentinosarcoma 9330/3”
“Chondrosarcoma, grade 1 9222/3”
“Chondrosarcoma, periosteal 9221/3”
“Clear cell chondrosarcoma 9242/3”
“Dedifferentiated chondrosarcoma 9243/3”
“Conventional osteosarcoma 9186/3”
“High-grade surface osteosarcoma 9194/3”
“Radiation-induced osteosarcoma 9184/3”
“Small cell osteosarcoma 9185/3”
“Telangiectatic osteosarcoma 9183/3”
“Rhabdomyosarcoma with TFCP2 rearrangement 8900/3”

Table 8: Tumors of Ear
Rows added:
“Ceruminous adenocarcinoma 8420/3”
“Middle ear neuroendocrine tumor 8240/3”

H&N Multiple Primary Rules
Rule M3, bullet added "Aortic body C755 AND carotid body C754"