01-10-2025 EIN Staging-revised instructions!
Scenario
- 72 yo female presented to physician with post-menopausal bleeding
- 1/4/2025 Transvaginal US was done which revealed a large, 9.7 cm, endometrial mass with differential diagnosis of large polyp, endometrial hyperplasia, or endometrial malignancy
- 1/12/2025 CT Abd/Pelvis was done with endometrial thickening better seen on US, no evidence lymphadenopathy
- 1/17/2025 TAH-BSO done: Large endometrial polyp, 9.0 cm, with spectrum of simple hyperplasia to focal atypical hyperplasia/endometrial intraepithelial neoplasia (EIN), no peritoneal washings or nodes present
Question: How would you assign pathological staging?
- pT BLANK pNX cM0 – Stage 99
- pT0 pNX cM0 – Stage 99
- pT1 cN0 cM0 – Stage 1
- pT1 pNX cM0 – Stage 99
Answer: pT BLANK pNX cM0 – Stage 99
Rationale:
Endometrial intraepithelial neoplasm or EIN became reportable in 2021 and is assigned to histology 8380/2. In the past, we were instructed to code to pT1, since there is no Tis category, however, new information/clarification has come to light, and the new advisement now is leading us to believe that they would like EIN to be assigned as T BLANK.
Please refer to the CAnswer forum for further discussion/details. https://cancerbulletin.facs.org/forums/node/151018#post159470