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20051003 | CS Tumor Size/CS Eval--Breast: How are these fields coded when there is a clinical size recorded but the tumor size is not specified on the pathology report associated with a subsequent resection? See Discussion. | 4/8/04 excisional biopsy of 1.5 cm palpable mass. Path: gives a specimen size only and states that there is a nodular firm area that correlates with the clustered microcalcification on radiograph. No pathologic tumor size is given. Would the size be coded to the clinical size of 1.5 cm? The patient did have surgery but the only size available is a clinical one. Because the size is clinical, is the CS Eval field coded to 0 [No surgical resection done. Evaluation based on PE...]? | 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. Clinical size can be coded when the patient has had surgery. For the case above, code the tumor size as 015 [1.5 cm] using the clinical information. The CS Tumor Size/Extent Eval field refers to both tumor size and extension. In this case, record the eval field as 0 or 1 (which ever is appropriate). The tumor size sets the T category unless the resection shows skin or chest wall or dermal lymphatic involvement. |
2005 |
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20051002 | CS Tumor Size/CS Site Specific Factor 6--Breast: How are these fields coded for a tumor stated to have only in situ disease in the breast with bone metastasis identified on scan? See Discussion. | 4/20/04 Quadrantectomy: "Tumor involves a significant portion of the biopsy and is estimated at 10 cm in greatest dimension." The only other mention of size is from imaging studies which is 3.5 cm. The histology is "high grade ductal carcinoma with comedo necrosis. No invasive carcinoma identified." Bone scan on 4/20/04 shows "widespread metastatic disease to bone." By rule the behavior code for this case is changed to malignant. | 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. Code tumor size as 100 [10 cm]. Size from pathology or operative report is preferred over size from imaging.
Code SSF6 as 050 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated and proportions of in situ and invasive not known.]
There is invasive tumor present (as proven by the bone metastasis), but the size and proportion of the invasive component is unknown.
Please note: Extension must be coded at least to 10 [Confined to the breast tissue and fat including nipple and areola; Localized, NOS] in this case. Do not assign extension code 00 [in situ]. |
2005 |
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20051006 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Thyroid: How is histology coded for the tumor(s) that exist when the thyroidectomy addendum diagnosis is "Morphologic and IHC evaluations reveal two tumors: papillary thyroid carcinoma and squamous cell carcinoma." See Discussion. | The original final diagnosis after a thyroidectomy is "papillary carcinoma of the thyroid with an adjacent invasive squamous cell carcinoma, moderately differentiated." Per the additional addendum comment: "The findings can be interpreted in one of 2 different ways. Either there is a collision tumor of papillary thyroid and squamous cell carcinoma (with the squamous cell ca originating at a site other than the thyroid gland.) Or, less likely, there is a malignant squamous differentiation in the papillary thyroid carcinoma." A university hospital consultation report states the diagnosis as: "Spindle cell squamous cell carcinoma arising in association and from papillary carcinoma, predominantly tall cell variant..." Is this 2 thyroid primaries: 8344/3 [papillary carcinoma, tall cell] and 8074/3 [squamous cell carcinoma, spindle cell]? | For tumors diagnosed prior to 2007:
Our pathologist consultant agrees with the consultant's diagnosis. Therefore, abstract this as one primary of the thyroid. Code the histology as 8344 [Papillary tall cell]. This is the most appropriate histology code available for this complex case.
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. |
2005 |
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20051013 | Reportability/In Situ--Prostate: Was there a time period when PIN III was reportable to SEER? | Per the 2004 SEER Manual, page 2, Reportable Diagnoses, Exceptions, 1.b.iii "Prostatic intraepithelial neoplasia (PIN III) of the prostate (C619). (Collection stopped effective with cases diagnosed 1/1/2001 and later.)" | 2005 | |
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20051022 | Primary Site--Breast: Would a tumor described as located "lower central" be coded to C501 (central) or C508 overlapping (lower)? | Code the primary site C501 [Central portion of breast]. Based on the description above, the tumor is located in the central portion of the breast. | 2005 | |
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20051127 | Reportability--Brain and CNS: Is an "intradural extramedullary schwannoma (neurilemoma)" of the spine reportable? See Discussion. | Example: Pt underwent laminectomy and excision of intradural extramedullary tumor. Is there a default decision for tumors described as intradural extramedullary tumors, NOS? |
For cases diagnosed 2011 and later: A spinal "intradural extramedullary schwannoma (neurilemoma)" is reportable. This schwannoma originated in the spinal nerve root, C720.
See #2 under Reportability in the Data Collection Answers from the CoC, NPCR, SEER Technical Workgroup, http://www.seer.cancer.gov/registrars/data-collection.html#reportability |
2005 |
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20051135 | 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. |
2005 | |
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20041088 | CS Extension/EOD Extension--Renal Pelvis: Primary site is renal pelvis with direct extension to the rt adrenal gland. What is the correct extension code? | 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 Extension code 67 [Adrenal gland from renal pelvis] for adrenal extension from renal pelvis -- T4 and regional direct extension. |
2004 | |
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20041053 | CS Site Specific Factor 6--Breast: Can we interpret the in situ component as "minimal" when the pathology report states "1.1 cm infiltrating duct carcinoma and no extensive intraductal component"? | 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. Yes. Based on the information provided above, the in situ component is "mininmal" for the purpose of coding Breast CS Site Specific Factor 6. The phrase "no extensive intraductal component" suggests that there is some intraductal carcinoma present. |
2004 | |
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20041036 | Surgery of Primary Site/Surgery codes, NOS--Colon: What tissue specimens are included under this field's code 41 [Subtotal colectomy/hemicolectomy plus resection of contiguous organ; example: small bowel, bladder]? See Discussion. |
How is site specific surgery coded for the following two cases? Example 1. A right hemicolectomy normally includes a portion of ileum. Example 2. Subtotal colectomy with bilateral oophorectomy. |
Code 40 includes a right hemicolectomy. A right hemicolectomy normally includes a small portion of the terminal ileum removed with the ileocecal valve. Assign code 41 when resection of CONTIGUOUS organs goes beyond what would normally be removed as part of a subtotal colectomy/hemicolectomy. Record non-contiguous organ resection in Surgical Procedure of Other Site. Example 1: Surgery of Primary Site -- 40 [Subtotal colectomy/hemicolectomy]. Example 2: Surgery of Primary Site -- 40 [Subtotal colectomy/hemicolectomy]. Surgical Procedure of Other Site -- 2 [Non-primary surgical procedure to other regional sites]. Addendum July 2021 For coding Surgical Procedure of Other Site, see the instructions for determining regional vs distant sites in the 2021 SEER manual under Coding Instructions #6 and #7 on pages 184-185. Do not use Summary Stage to determine regional vs distant for this data item. |
2004 |
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