2004 SEER Manual Errata/CS Tumor Size--Can the Determining Descriptive Tumor Size information, on page 6 in the SEER EOD Manual, January 1998, be used to code descriptive tumor size in Collaborative Stage?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
Use the instructions in the CS Manual, Appendix 1, page 62. This information will be added to the 2004 SEER manual in the next update.
Do not use the Determining Descriptive Tumor Size information from EOD for CS Tumor Size.
Date of Diagnosis--Sarcoma: Should the date of diagnosis be coded to the date of biopsy or the date of birth for an infant biopsied at 3 days of age and stated to have a diagnosis of congenital alveolar rhabdomyosarcoma, widely metastatic?
Code the date of the biopsy as the date of diagnosis. This is the date the cancer was first identified by a medical practitioner.
Note: SEER collects the Month and Year of diagnosis. The "day" of diagnosis is not collected by SEER.
CS Extension/CS Mets at Dx--Pineal Gland: In Collaborative Stage, how is positive cerebral spinal fluid coded?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign CS Mets at DX code 40 [Distant metastases] for a pineal gland primary with positive cerebral spinal fluid.
CS Lymph Nodes/CS Site Specific Factor 3--Breast: How are positive intramammary lymph nodes reflected in these fields? See Discussion.
Patient with breast cancer underwent mastectomy. No axillary lymph nodes were positive, but 1 out of 2 intramammary lymph nodes were positive for mets (greater than 2 mm). CS Lymph node codes describe axillary and internal mammary nodes, but do not describe intramammary lymph nodes.
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
Intramammary lymph nodes are coded as axillary lymph nodes for staging purposes. Intramammary node are nodes within the breast tissue. Both staging and treatment suggest these are equivalent to axillary nodes.
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.
CS Extension/CS Lymph Nodes--Colon: What codes are used when large vessel invasion (V2 grossly evident) is stated to be present on a pathology report? See Discussion.
Example
Cecum, right hemicolectomy: poorly differentiated invasive adenocarcinoma of the cecum. Large vessel invasion (V2-grossly evident) is present. Microscopic description: The grossly described matted lymph node tissue shows an irregular nuclear contour and is classified as V2, grossly evident venous invasion based on staging criteria of the AJCC Cancer Staging Manual, 6th Edition.
Per note 2 in the coding scheme for CS-Extension, a nodule with irregular contour in the pericolic adipose tissue should be coded in CS-Extension to code 45. Is the large vessel invasion described in the path report the same process as a tumor nodule in pericolic fat? Should note 2 be used and CS-Extension coded to 45?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.The description of large vessel invasion and irregular nuclear contour from the example above describes grossly matted LYMPH NODE tissue. Do not code this in the CS Extension field. Code the CS Lymph Nodes field appropriately based on the rest of the information for this case.
When large vessel invasion and irregular nuclear contour is used to describe a "tumor nodule," rather than a recognizable lymph node, code it in the CS extension field.
CS Site Specific Factor--Prostate: Is there an established range of values that can be used to code negative, borderline or elevated PSA values? See Discussion.
Previous SEER prostate coding guidelines listed a PSA range that could be used to code negative, borderline, or elevated values in the absence of any statement concerning elevated PSA in the medical record. Is this still in effect for SSF 2, or do we need a definite statement when only a numeric value is given?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
This matter is under consideration by the CS Steering Committee. The CS Steering committee is reviewing options for incorporating SEER guidelines into the CS manual.
Multiple Primaries--Lymphoma: How many primaries should be reported when there is a marginal zone B-Cell lymphoma [9699/3] diagnosed in 2000, and the clinician states that the diffuse large B-Cell type lymphoma [9680/3] diagnosed in 2004 was a transformation of the prior primary? See Discussion.
The Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates they are most likely "D" different disease processes. As any low grade lymphoma can transform, we suspect this represents a transformation (the clinician is regarding this as transformed).
How many primary/ies should be coded?
And, how?
For cases diagnosed prior to 1/1/2010:
Report this case as one primary according to the physician's opinion. Code the histology as 9699/3 [marginal zone B-Cell lymphoma, NOS] and code the date of diagnosis as 2000.
Code the physicians opinion regardless of whether or not it agrees with the Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table. Use the table when the physician does not state whether or not there is a new primary.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
First Course Treatment/Surgery of Primary Site--Lung: How is radiofrequency ablation for lung primaries coded?
Assign code 15 [Local tumor destruction, NOS] in the Surgery of Primary Site field. RFA is a technique where a probe placed in or near a tumor sends radio waves into the tumor, causing it to heat up and kill the cancer cells. RFA doesn't fit neatly into code 12 or 13, so we are left with the NOS code.
Reportability--Hematopoietic, NOS: Is a "myeloproliferative disorder" reportable when the pathology report comment states this likely represents the "early/cellular phase of myelofibrosis/myeloid metaplasia" with cytogenetics and PCR pending?
For cases diagnosed prior to 1/1/2010:This case is not yet reportable. The bone marrow diagnosis "myeloproliferative disorder" is not reportable to SEER. It is likely that if this condition progresses, it will eventually be reportable.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
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