Tumor Tips

Tumor Tip of the Week 11-21-2025 How many lung primaries?

11-21-2025

Scenario: Case abstracted after Registry Software converted to v25

  • 01/15/2023: LUL Wedge with Invasive Acinar Adenocarcinoma with Lepidic Component
  • 3/14/2024 MD states: CT chest shows multiple ground glass opacities and multiple part solid nodules and stable mediastinal adenopathy.  Overall, these changes are concerning for malignancy
  • 10/18/2024 RUL transbronchial biopsy: Lepidic Adenocarcinoma
  • Post biopsy PET states there are multiple ill-defined nodules and ground glass nodules within both lungs. Grossly stable w/interval enlargement of RUL nodule.
  • Med Onc states not a surgical candidate and patient starts treatment.

Question: How many primaries?

  • Single
  • Multiple

Answer: Multiple

Solid Tumor Rules Lung Rule M6 Abstract multiple primaries when separate/non-contiguous tumors are two or more different subtypes/variants in Column 3, Table 3 in the Equivalent Terms and Definitions. Timing is irrelevant.

  • Seq 01 dx 01-15-2023 LUL 8551 Acinar Adenocarcinoma
    • Solid Tumor Rules Lung-Terms that are NOT Equivalent or Equal-Component is not equivalent to type/subtype/variant so left with Acinar Adenocarcinoma
  • Seq 02 dx 10-18-2024 RUL 8250 Lepidic Adenocarcinoma

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