Other Therapy: What code is used to represent treatment with "Epithilone" or "Epothilone"?
Code the Other Cancer-Directed Therapy field to 2 [Other experimental cancer-directed therapy (not included elsewhere)], until the exact mechanism of action is determined for this drug. This drug is in phase I clinical trials. It has a similar action to Taxol, but is derived from a different source.
Reportability--Appendix: Are low-grade appendiceal mucinous neoplasms reportable?
For cases diagnosed prior to 1/1/2022
A low-grade appendiceal mucinous neoplasm (LAMN) is not reportable. The WHO classification designates LAMN with the behavior code /1 [uncertain whether benign or malignant].
Multiple Primaries (Pre-2007)--Vulva/Vagina: SEER Program Code Manual rule #3 on page 11 states "If a new cancer of the same histology is diagnosed in the same site after two months, consider this new cancer a separate primary unless stated to be recurrent or metastatic. Should vulva and vagina be exceptions to rule #3, as are prostate and bladder?
For tumors diagnosed prior to 2007:
No. There is no exception for vulva or vagina.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.
Primary Site--Bladder: What subsite is used for fundus of the bladder?
As of November 2005, Code fundus of bladder to C678 [overlapping lesion of bladder]. Opinions vary regarding the definition of bladder "fundus." However, according to our pathologist consultant, fundus includes posterior, anterior and lateral walls and dome. Fundus does not include the trigone.
A correction to page C-595 of the 2004 SEER manual will be included in the next errata.
Chemotherapy--Breast: In the absence of more specific information, is the insertion of a port-a-cath one month after mastectomy enough documentation to code chemotherapy to 88 [Recommended]?
Assign chemotherapy code 88 [Chemotherapy was recommended, but it is unknown if it was administered]. Be sure to confirm whether or not treatment was administered and update this code accordingly.
Reportability/Histology--Skin: Is dermatofibrosarcoma protuberans (DFSP) with fibrosarcomatous overgrowth, DFSP with fibrosarcomatous component Grade 2, or DFSP with focal myxoid features (2022) reportable for 2021-2022 diagnoses?
Yes. DFSP with fibrosarcomatous overgrowth and DFSP with fibrosarcomatous component Grade 2 are synonymous with fibrosarcomatous DFSP (8832/3). Our expert pathologist also advises that DFSP with focal myxoid features is the same as DFSP, myxoid (8832/3).
Reportability/Histology--Soft Tissue: Is atypical spindle cell neoplasm, primitive myxoid mesenchymal tumor of infancy (PMMTI) from the soft tissue of the leg in August of 2019, reportable?
Primitive myxoid mesenchymal tumor of infancy (PMMTI) is reportable. PMMTI is listed in the new WHO 5th edition Classification of Soft Tissue and Bone Tumors under round cell sarcomas. This is a variant of BCOR sarcomas. There is a new ICD-O histology code assigned for cases diagnosed in 2022 or later (9368/3). Code this 2019 case to round cell sarcoma, undifferentiated 8803/3. Use text fields to explain the details.
Multiple Primaries (Pre-2007)/Recurrence--Cervix: How many primaries should be abstracted if a patient had a diagnosis in 1998 of adenocarcinoma in situ of the cervix treated with a total hysterectomy and a July 2004 vaginal mass biopsy with a diagnosis of invasive adenocarcinoma that is consistent with an endocervical primary?
For tumors diagnosed prior to 2007:
Abstract the July 2004 diagnosis as a new endocervical primary. Abstract an invasive cancer in the same site more than two months after an in situ cancer as a new primary. Residual cervical tissue is present following a hysterectomy.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.