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Report Produced: 09/20/2025 07:03 AM

Report Question ID Question Discussion Answer Year
20081079 Ambiguous terminology/Reportability--Kidney: Is a case reportable if a biopsy diagnosis of "suggestive of oncocytoma, malignant neoplasm cannot be excluded" follows a CT scan that was read as "suspicious for carcinoma"? See Discussion. Pt is nursing home resident. CT abdomen/pelvis shows a "mass in the right kidney, highly suspicious for renal cell carcinoma". CT-guided needle biopsy performed with final diagnosis: "Neoplasm suggestive of oncocytoma. A malignant neoplasm cannot be excluded." No other information is available. This case is not reportable based on the information provided. The suspicious CT finding was biopsied and not proven to be malignant. "Suggestive of" is not a reportable ambiguous term. 2008
20081108 CS Extension--Pancreas: How is this field coded for a head of pancreas primary with involvement of the inferior vena cava?

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 54 [Blood vessel(s) major]. The inferior vena cava is one of the major blood vessels.

The inferior vena cava is located just behind the head of the pancreas. The hepatic artery, the superior mesenteric vessels and the portal vein are nearby.

 2008
20081075 Race, ethnicity/Spanish surname or origin: SEER Program Manual instructions state, "Portugese, Brazilians and Filipinos are not Spanish; Code non-Spanish (code 0)." How is that determined? Is that based SOLELY on birthplace? See Discussion.

The following are scenarios for which we would like clarification on how to code Spanish Ethnicity.

  • Birthplace Portugal; text states Spanish, south American or European Spanish

  • Birthplace Brazil, last name is on Spanish surname list; pt is married female. Text states "Hispanic female, NOS"

  • Birthplace Brazil or Portugal, text states patient is "Mexican", last name is on Spanish surname list

    • Information about Spanish origin is available for both of these cases; code the race as Hispanic. Use the SEER manual instruction when the only information available is that the patient was born in Portugal, Brazil or the Philippines. In the absence of additional information, do not assume Hispanic. However, if additional information is available stating that the patient is Hispanic, code as Hispanic.

    Spanish Surname or Origin Scenarios

  • 6 [Spanish, NOS; Hispanic, NOS; Latino, NOS]

  • 6 [Spanish, NOS; Hispanic, NOS; Latino, NOS]

  • 1 [Mexican (includes Chicano)]

    		• 2008
    		20081041 MP/H Rules/Histology--Thyroid: How many primaries are to be reported and what histology is to be coded for an anaplastic/undifferentiated thyroid carcinoma with sarcomatoid transformation likely arising in association with a papillary thyroid carcinoma? Thyroid contains one tumor: 12.5 cm in greatest dimension...almost completely replaces entire thryroid gland.

    For cases diagnosed 2007 or later:

    This is a single primary using rule M2; a single tumor is always a single primary.

    The histology code for this case is 8260/3 [Papillary carcinoma of thyroid]. Begin with Histology Coding rule H8. Stop at rule H17 and code the histology with the numerically higher ICD-O-3 code.

    		 2008
    		20081055 MP/H Rules--Melanoma: How many primaries are represented if subsequent to a diagnosis of malignant melanoma of skin of left thorax in April 2006, a metastatic melanoma is discovered in the soft tissue of the abdomen and in the skin and subcutaneous tissue of the groin in late 2007? See Discussion.

    4/20/06: skin left lateral thorax, excision: Pedunculated malignant melanoma, 0.5 CM in height, Clark's level 3, Breslow depth 0.5 CM, superficial ulceration noted. No host response. Margins clear.

    6/19/06: Four sentinel LNs negative. Interferon therapy.

    10/30/07: FNA of soft tissue, left lower abdomen: consistent with metastatic melanoma.

    12/20/07 A) sentinel lymph node, left groin, biopsy: No morphologic or immunophenotypic findings support for metastatic melanoma (see comment). B) skin and subcutaneous tissue, left groin, excisional biopsy: Metastatic malignant melanoma (see comment). Lymphovascular invasion identified. Margins free of melanoma. Melanoma 1.5 MM from the closest designated deep margin and 5 MM from the designated 6:00 margin. C) skin, left groin/additional inferior margin, excisional biopsy: No significant histopathologic abnormality. No evidence of villus or melanoma or malignancy. Comment: A 0.8 cm metastatic nodular melanoma is present in the adipose tissue. The underlying skin is unremarkable. There is no evidence of ulceration, melanocytic lesion, melanoma in situ, or regression of melanoma. Block A1 is sent for immunohistochemical studies. The immunophenotypic findings provide no support for metastatic melanoma in lymph node. Please see the immunohistochemical study. The primary MD states "Recurrent intransit mets, left groin."

    		 For cases diagnosed 2007 or later, this is a single primary, melanoma of the thorax 4/20/06. The subsequent reports mention metastases, but do not document another primary. Do not count metastatic lesions as new primaries. 2008
    		20081067 CS Extension--Lymphoma: When does the coding change take effect that is referred to in SEER edit IF195, that states localized lymphoma in primary sites C024, C090-099, C111, C142, C172, C181, and C379 must be coded to CS extension 10, and cannot be coded to extension 11? See Discussion. CS version 1.04 does have a new note 1 in the lymphoma scheme that appears this coding change. In the past, we used code 11 with these sites for localized lymphoma and SINQ 20061088 confirms this line of thinking.

    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 change was made with the release of CS version 01.04.00 on October 31, 2007. The rules went into effect for cases diagnosed January 1, 2008 and later. A note was added to SINQ 20061088 stating that the answer pertains to cases diagnosed prior to January 1, 2008.

    		 2008
    		20081026 MP/H rules/Multiple primaries: Is a 2007 cytology diagnosis of adenocarcinoma in bile duct a new primary for a patient with a 2005 diagnosis of adenocarcinoma of gallbladder? See Discussion.

    A case abstracted for an adenocarcinoma of gallbladder (C23.9) in 2005. In 2007, cytology diagnosis of adenocarcinoma in bile duct(C24.0). Oncologist calls this recurrence. There is no pathologist statement of recurrence.

    Using Other Sites multiple primary rules, rule M10 indicates this is multiple primaries. Sequence 01 dx in 2005 and sequence 02 dx in 2007. Is this correct? There is no statement of a primary tumor; the MP/H rules talk in terms of mass, lesion, tumor in a primary site.

    		 For cases diagnosed 2007 or later, abstract the 2007 bile duct diagnosis as a new primary unless it is described as metastatic. 2008
    		20081141

    MP/H Rules--Lung: How do we interpret 'spiculated opacities?' How many primaries do we abstract for this patient? See Discussion.

    Patient admitted for CT scan of chest. Impression: A small subpleural spiculated opacity is noted in the left upper lobe measuring 9.7x7.7mm. Right upper lobe spiculated nodular opacity measures 13.9x5.9mm. Right lower lobe scattered faint alveolar nodular opacities are noted. The lungs are otherwise clear. Abnormal soft tissue density mass is noted of the right hilum surrounding the distal main right pulmonary artery. Bronchoscopy/mediastinoscopy done: rare malignant cells present consistent with small cell carcinoma, specimen submitted as brushing of right bronchus intermedius. The tumor in the lymph node is metastatic small cell carcinoma. Patient discharged to hospice; died 5 weeks later.

    Do the MP/H rules pertain only to the measured opacities in each lung and not to the RLL scattered faint alveolar nodular opacities? The right side was cytologically confirmed. But if we abstract the left lung, what is the histology...8041 or 8000?

    For cases diagnosed 2007 or later:

    Because there was cytologic confirmation of cancer, for this case only count the spiculated opacities as tumors. Abstract as a single primary using Rule M1. Note 2 under lung rule M1 applies to this case.

    Code the histology as 8041 [small cell carcinoma] per rule H10.

    		 2008
    		20081011 Surgery of Primary Site/CS Reg LN Exam/Scope Regional LN Surgery--Rectum: How are these fields coded when a patient develops a non-tumor related complication that requires an additional sigmoid resection that removes 2 additional lymph nodes one week following a low anterior resection that removed 4 lymph nodes? See Discussion. Patient had a low-lying rectal cancer that was biopsied and then treated with radiation and chemo followed by a low anterior resection. Four nodes were removed. There was no residual tumor. The patient returned one week later due to a rectal bleed, thought to be an abscess. During surgical exploration it was found that the anastomosis had broken down and it was decided to do a sigmoid colectomy. Residual disease was not suspected. Two additional nodes were removed.

    Surgery of primary site: Assign code 30 [low anterior resection]. Code the most extensive surgery (i.e. the highest surgery code) applicable.

    CS Reg LN Exam: Code 04 [four nodes removed].

    Scope of regional lymph node surgery: Code 5 [4 or more regional lymph nodes removed].

    The sigmoid colectomy was performed for a surgical complication, thus it was not cancer-directed therapy. The regional lymph nodes removed during that procedure were not removed to diagnose cancer or stage the disease, and they were not removed during the initial treatment. Please see SEER manual for instructions for coding Regional Lymph Node Surgery.

    		 2008
    		20081089 Multiplicity Counter--Thyroid: How is this field coded for a tumor described as "multinodular carcinoma of the thyroid"? See Discussion. This information is from a pathology report. No other information is available. Count the number of measured nodules. If the nodules are not measured, code 99 in the multiplicity counter. 2008