2022-03-21 - Cancer Synoptic Reporting Project Group Meeting

Sorry for being late yesterday, I wasn't aware of the change of time.

Just a brief comment on the metastasizing benign entities: There is a discussion on benign metastasizing leiomyoma in Rosai's textbook (current 11th edition p1328):

. . . We favor the designation of low-grade leiomyosarcoma, once these bland tumors have been found to metastasize and thus declared their biological potential; in this regard, it may be opportune to quote here Julian Huxley—the famous biologist, zoologist, humanist, and popular writer—who, in his lecture on “Biological aspects of cancer,” given at the Sloan Kettering Institute in 1955, stated when discussing the policy for designating lesions solely on the basis of their morphology: “This seems a regrettable example of specialist scholasticism. Cancer (malignancy) must be defined operatively in terms of what the tumor cells do, not what they look like; otherwise the term ceases to have biological meaning.”

In another paragraph, he also refers to pleomorphic adenoma.

^{Following this argumentation, I would model every metastasized neoplasm as malignant, being aware, that for some neoplasms histology might fail to adequately predict this behavior. Regarding terminology, I would suggest not to model any benign metastasizing disorders.}

^{Same should refer to neuroendocrine tumors: If I understand correctly, the term tumor has been adopted to highlight that patients with metastasis have an excellent survival.}

^{In the same line of argumentation I would suggest to model noninvasive papillary carcinoma of the urinary tract to subsume under benign neoplasms, intraepithelial neoplasia or precancerosis despite its designation.}