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SEER Inquiry System - Report
Produced: 11/25/2024 3:36 PM
Question 20031101
Inquiry Details
References:
SEER EOD-88, 3rd Ed, 78
Question:
Discussion:
The managing physician has staged this pathologically as T4 N0 M0 squamous cell carcinoma of the ethmoid sinuses. The final pathology report says " Sinus, sphenoid, resection: papillary neoplasm most consistent with inverted papilloma with squamous cell carcinoma in situ, 7 cm in greatest extent, focus of probable superficial invasion (see comment).
Soft tissue, skull base, excision: involved by papillary neoplasm with squamous cell carcinoma in situ (see comment). Brain, extradural, intercranial biopsy: involved by papilloma with squamous cell carcinoma in situ. COMMENT:
This is a predominantly exophytic neoplasm with infolding of the tumor epithelium and in situ extension into submucosal glands. There are only focal areas suspicious for invasive squamous cell carcinoma, with probable invasion (<2mm) in one section....The histologic features are most consistent with an inverted papilloma with carcinoma in situ." When asked to comfirm if the diagnosis were in situ or superficially invasive, the pathologist responded "Squamous cell carcinoma in situ involving a papilloma. Locally aggressive but not technically invasive."
Answer:
Code site to C31.3 [sphenoid sinus]. Code the site based on the final pathology report diagnosis. In the case example, the site attributed to the managing physician appears to be an error.
Code behavior to 3 [malignant, primary site]. The SEER list of terms meaning involvement may be used to help determine behavior. The terms used by the pathologist are "probable" superficial invasion and "suspicious" for invasive squamous cell carcinoma with "probable" invasion. Interpret as invasive.
For cases diagnosed 1998-2003: Code extension to 70 [Brain] because this tumor involves the brain.
