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Report Produced: 01/14/2026 05:13 AM

Report Question ID Question Discussion Answer Year
20041058 Primary Site/Sarcoma--Breast: Is the primary site coded to C504 [upper-outer quadrant of breast] or C493 [ Connective, subcutaneous and other soft tissue of thorax ] for a tumor described as a "high grade soft tissue sarcoma present in the upper outer quadrant of breast"? If the sarcoma is primary in the breast, code the primary site to C504 [upper-outer quadrant of breast]. C500 - C509 includes soft tissue of breast. 2004
20041050 Surgery of Primary Site--Rectum: How do you code a procedure described as a "transanal resection, debulking of a large rectal mass"? See Discussion. Patient is not a surgical candidate due to "other medical conditions". Colonoscopy done for anemia and rectal bleeding. At the colonoscopy a "Transanal Resection Debulking of large rectal mass" is performed. Two specimens are sent to the lab. The first is labeled "rectal mass" and is a 2.0 cm diameter spherical fragment of tissue. The second is labeled "transanal debulking rectal mass" and is described as multiple, irregular shaped fragments of tan, rubbery tissue measuring 5.0 x 5.0 x 3.0 cm. Final path diagnosis: Debulking of rectal mass: Adenocarcinoma greater than 2 cm in size, resection margins positive for tumor. For cases diagnosed 1998-2002, code Surgery of Primary Site to 20 [Local tumor excision, NOS]. Because the procedure was performed via colonoscopy and apparently did not involve proctectomy, the best choice is a local excision. 2004
20041019 EOD-Extension--Lung: Is this field coded to 10 [tumor confined to one lung] or 20 [Tumor involving main stem bronchus >= 2 cm from carina] when there is no mention of the mainstem bronchus and a lobectomy is performed? See Discussion. The clinical work-up shows a mass at the left medial apex extending into the left lung. No mention of the main stem bronchus. Because a lobectomy was performed, we assume, per Note 2, that the tumor was greater than or equal to 2 cm from the carina. For cases diagnosed 1998-2003: Code the EOD-Extension field to 10 [tumor confined to one lung] for the case example. The EOD-Extension code 20 [Tumor involving main stem bronchus >= 2 cm from carina] applies to tumors involving the main stem bronchus. 2004
20041006 Multiple Primaries (Pre-2007)/Date of Diagnosis--Bladder: How is date of diagnosis coded when metastases consistent with a bladder primary are found more than a year after a diagnosis of non-invasive bladder cancer? See Description. A non-invasive papillary transitional cell carcinoma is removed by TURB in May 2002. In January 2003, a bone biopsy reveals metastatic transitional cell carcinoma consistent with bladder primary.

For tumors diagnosed prior to 2007:

Code a second bladder primary diagnosed in January 2003.

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.

 2004
20041047 Multiple primaries (Pre-2007)/EOD-Extension--Fallopian Tube: How many primaries are coded when endometrioid adenocarcinoma involves bilateral fallopian tubes? See Discussion. The pathologist states "because of the intimate association with the luminal line of the fallopian tube it is felt that this represents synchronous primaries rather than mets." The SEER Code Manual only lists ovary, retinoblastomas, and Wilms Tumors under the bilateral code stated to be a single primary.

For tumors diagnosed prior to 2007:

Complete two abstracts, one for left fallopian tube and one for right fallopian tube. This case has been determined to be two primaries by the pathologist. Bilateral involvement of paired sites (other than ovary, retinoblastoma and Wilms tumor) with the same histology within two months requires a determination of whether there are one or two primaries. The pathologist in the case above has made this determination.

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.

 2004
20041054 CS Extension--Prostate: For a tumor that is clinically inapparent, but a biopsy from the prostatic apex is positive, is this field coded to 15 [Tumor identified by needle biopsy, e.g., for elevated PSA (clinically inapparent)]?

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. Code CS Extension-Clinical Extension to 15 [Tumor identified by needle biopsy, e.g., for elevated PSA (clinically inapparent)] for clinically inapparent prostate cancer with positive apex biopsy.

 2004
20041076 CS Extension--Colon: What is the difference between codes 46 [Adherent to other organs or structures, but no microscopic tumor found in adhesion(s)] and 57 [Adherent to other organs or structures, NOS]? See Discussion.

Code 46 reads "Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)".

Would these examples be coded to 46?

Example 1: 7/04 Op findings: mass was adherent to duodenum without obvious invasion. Path: margins negative (no mention of duodenum). Case staged to pT3.

Example 2: Op findings: large mass involving cecum adherent to peritoneum & retroperitoneum. Path: invasion of pericolic soft tissue; margins negative (no metion of peritoneum & retroperitoneum). Case staged to pT3.

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 46: Attached to other organ (on imaging or surgical observation); pathology says no invasion of the other organ. Code 57: Attached to other organ; pathology is positive for invasion of other organ, or pathology does not specify whether there is invasion of the other organ.

Example 1: Code extension to 46 [Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)]. The tumor was attached to the duodenum, but not invading

Example 2: Code extension to 46 [Adherent to other organs or structure, but no microscopic tumor found in adhesion(s)]. The tumor was attached to peritoneum & retroperitoneum, but not invading based on negative margins and no peritoneum or retroperitoneum specimen submitted to pathologist.

 2004
20041013 Primary Site--Ovary/Peritoneum: Should this field be coded to ovary or peritoneum when the bulk of the tumor is in the peritoneum and there is only surface involvement of the ovary?

If it is not clear where the tumor originated, use the following criteria to distinguish ovarian primaries from peritoneal primaries.

The primary site is probably ovarian, unless:

--Ovaries have been previously removed

--Ovaries are not involved (negative)

--Ovaries have no area of involvement greater than 5mm.

Descriptions such as "bulky mass," "omental caking" probably indicate an ovarian primary.

Descriptions such as "seeding," "studding," "salting" probably indicate a peritoneal primary.

 2004
20041080

Behavior Code/CS Extension--Brain and CNS: How are these fields coded when the final diagnosis on pathology indicates that an atypical meningioma invades the brain and the bone flap specimen indicates extensive invasion through the full thickness of the calvarium? See Discussion.

FDx on the path is: A. Rt frontotemporal brain tumor: Atypical meningioma, WHO grade II (out of III). B. Arachnoid tissue: Atypical meningioma with small focus of invasion into superficial brain and focal perivascular spread. C. Bone flap: Atypical meningioma with extensive invasion through full thickness of the calvarium.

Comment: Although this tumor shows a small focus of brain invasion, it should be considered a grade II (out of III) meningioma based on its histologic atypia (cellularity, sheeting of tumor cells and prominent nucleoli), elevated Ki-67 index and low mitotic rate.

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.For tumors diagnosed prior to 2004, the example above is a benign meningioma and not reportable to SEER.

For tumors diagnosed 2004 or later, code the behavior as 1 [Borderline malignancy]. Code CS Extension as 05 [Benign or borderline brain tumors].

According to expert consultant, meningiomas are in the lining cells for the inner table of the skull and as such have an affinity for bone that allows them to penetrate adjacent bone without being "malignant.

 2004
20041102 CS Tumor Size--Breast: How is this field coded when a core needle biopsy removes the majority of the tumor? See Discussion.

Rule 4.j on page 128 of the 2004 SEER Manual states "Do not code the tumor size from a needle biopsy unless no residual tumor is found on further resection".

Example: 3/04/04 core biopsy Rt breast grade 1 infiltrating ductal carcinoma tumor size 0.8cm. 3/10/04 Lumpectomy: 3mm focus of residual infiltrating ductal carcinoma. If we can not take the size of the core needle biopsy, do we use the residual size of 3mm or the clinical size which was 1cm on mammogram?

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 the tumor size from the mammogram. Do not code the tumor size from the needle biopsy because residual tumor was present in the lumpectomy specimen.

 2004