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Default the coding of the Primary Site field for chordomas to the bone where the tumor began in the body if the primary site is not clearly stated to be soft tissue. Bone is often the primary site for chordomas.

Based on advice from pathologist consultants: This is one of those situations where we can be quite comfortable with a default, in this case to bone, not soft tissue. Chordoma is a tumor arising in the nucleus pulposis, presumably from remnants of notochord - thus its exclusive origin is in the sacrococcygeal region, spheno-occipital region, and vertebral bodies, otherwise known collectively as the axial skeleton. Any "chordoma" in soft tissue (with no relationship to axial skeleton) is probably a myxoid chondrosarcoma or parachordoma (extremely rare).

When you have information about home COVID tests, record this information. For example, if the home test was positive record as follows: COVID-19 rapid viral antigen test POS 08/09/2022

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.

For tumors diagnosed prior to 2007:

The best code is 8381/3 [Endometroid adenofibroma, malignant]. According to our pathologist consultant: "Serous 'fibroadenoma' is not exactly standard terminology. I would guess the pathologist is looking at an adenofibroma with more fibro and less adeno and thus has changed the terminology around. The combination of the benign serous and malignant edometrioid is also a bit unusual. Each of the proposed codes is defendable, but I prefer endometrioid adenofibroma, 8381/3, because it puts the tumor in the adenofibroma category (less common) yet still identifies the malignant element (endometrioid), even though it does lose the serous. But anyone wanting to look at malignant adenofibromas would find the case, and we would carry it under the appropriate malignant component."

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.

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 code 30 for positive unilateral superficial inguinal lymph nodes for cloacogenic primaries. The cloacogenic zone is part of the anal canal.

For cases diagnosed prior to 1/1/2010:This is one primary. Assign code 9590 [Malignant lymphoma, NOS]. This is a composite lymphoma. Code to lymphoma when there is any solid tumor (in lymph nodes, tissue, etc.) Code to lymphoma, NOS since this is not purely follicular and there is no code for composite lymphoma.

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.

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 CS Tumor Size as 1.0 cm. The pathology report is the highest priority source for coding tumor size. When multiple tumors are present, code the size of the largest tumor.

Assign code 8120/3, urothelial carcinoma, NOS, to urothelial plasmacytoma carcinoma of the bladder.  The WHO classification describes plasmacytoid variants of urothelial carcinoma. There is no specific ICD-O-3 code for these variants; however, and 8120/3 must be used.