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Report Produced: 05/01/2026 02:57 AM

Report Question ID Question Discussion Answer Year
20051020 CS Extension/CS Site Specific Factor--Breast: How is extension (localized or unknown) and SSF6 (entire tumor in situ or 888) coded for an in situ breast primary in which bone metastasis is diagnosed 4 months following the mastectomy? See Discussion. In situ breast primary with bone mets. No mets work up prior to mastectomy done 2/04. Path: 2.5 cm mass: ductal carcinoma in situ, solid type, with comedonecrosis (no invasive carcinoma found in mastectomy specimen). Bone scan done 4/04 showed compression fractures. MRI 6/04 showed diffuse metastatic disease of the bones.

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.

First, determine whether the bone mets in this case are progression of disease. If the patient was asymptomatic at the time of the mastectomy, the bone mets are disease progression, not initial stage.

If the initial stage includes the bone mets and they are not disease progression, extension must be coded to at least 10. Code site-Specific Factor 6 to 040 [Size of entire tumor coded, size of invasive component not stated].

 2005
20051125 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.

 2005
20051042 Histology (Pre-2007)/Diagnostic Confirmation: Which histology code is preferred if the CBD brushing is positive for malignant cells, cytologically most consistent with ductal adenocarcinoma [8500/3], and the common hepatic artery lymph node biopsy has metastatic adenocarcinoma, consistent with cholangiocarcinoma [8160/3]?

For tumors diagnosed prior to 2007:

Assign histology code 8160 [Cholangiocarcinoma]. Code from the pathology specimen when available. In this case, the only pathology is from the lymph node specimen.

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
20051117 CS Tumor Size--Bladder: Is tumor size coded to 080 when the bladder mass is described as "greater than 8 cm in diameter"?

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.Based on the information provided above, code CS tumor size 080 [8 cm]. Code the information that is avaliable. Since size of tumor is not used to stage bladder cancer, an approximation is adequate.

 2005
20051080 Priorities/CS Extension--Lung: In the absence of a physician TNM, is there a hierarchy associated with coding extension when multiple imaging studies demonstrate different degrees of extension? See Discussion. CT of the lung showing primary lesion and other nodules in another lobe or contralateral lung, subpleural nodules, etc. The PET scan did not show activity for the other nodules. What is our "hierarchy" for imaging studies when there is no physician staging?

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.

There is no hierarchy among the various imaging studies. Assign CS extension based on the report documenting the greatest extension.

 2005
20051086 CS Site Specific Factor 4--Prostate: For apex involvement at prostatectomy, is only apical involvement found at prostatectomy included or is all histologically proven apical involvement documented in the second digit of Site Specific Factor 4? See Discussion.

Per note 1 for Site Specific Factor 3 - Pathologic Extension all histologic information is used. Biopsy information would be included when coding path extension. Would all histologic information be used for coding prostatectomy apex involvement in Site Specific Factor 4?

Example 1: Prostate biopsies of the right and left apex and right and left mid gland show adenocarcinoma. Prostatectomy shows bilateral adenocarcinoma. Apex negative for tumor.

Example 2: Prostate biopsies of right apex and mid gland show adenocarcinoma. There is no mention of apex on prostatectomy path. How is CS Site Specific Factor 4 Prostate Apex Involvement 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 the second digit of CS SSF 4 based on prostatectomy only, do not include biopsy or other histologic information in the second digit.

According to the CS Steering Committee, the clinical or biopsy of the prostate is included in the first number of the code and should not be combined with the prostatectomy code which is the second number. These were separated purposely.

Example 1: Code the second digit of SSF 4 based on the prostatectomy, 1 [no involvement of prostatic apex].

Example 2: Code the second digit of SSF 4 based on the prostatectomy, 5 [apex extension unknown].

 2005
20051115 Histology (Pre-2007)--All Sites: How are "malignant cells" in a cytology or "probably malignancy" in a CT scan coded?

For tumors diagnosed prior to 2007:

Assign code 8001/3 [Tumor cells, malignant] when the only information available is a cytology report stating "malignant cells."

Assign code 8000/3 [Neoplasm, malignant] when then only information available is a CT report stating "probable malignancy."

See ICD-O-3 page 27 for an explanation of "cancer" [8000] and "carcinoma" [8010].

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
20051072 Primary Site/CS Extension--Lymphoma: Should CS Extension be coded to 22 [Involvement of spleen PLUS lymph node(s) BELOW the diaphragm] or 32 [Involvement of spleen PLUS lymph node(s) on both sides of the diaphragm] for the biopsy proven lymphoma in a retroperitoneal mass and a CT of the chest with nodes described as "indeterminate" or "calcified"? See Discussion.

It was diagnosed on CT-guided biopsy of retroperitoneal mass: obtained access to the posterior aspect of the lesion adjacent to the left side of the spinal column at approx the level of the kidney.

CT Abdomen/Pelvis: Large low attenuation & smooth walled regions in hilum of the spleen & into the splenic parenchyma w/assoc smaller lesions in the spleen. Associated adenopathy on left side of aorta between the superior mesenteric artery & renal vein.

Body of report: Soft tissue mass 4.4 x 4.8 x 7cm adjacent to the left side of the aorta & spanning the distance betw superior mesenteric vein inferiorly to level of left renal vein, appears to be matted adenopathy.

CT Chest: indeterminate nodes in pretracheal region w/calcified nodes in infracarinal region, right perihilar region & calcifications in pulmonary parenchyma of right lung. Calcified nodes & other structures suggest healed granulomatous process. However, with the infarct/mass lesion in the spleen & left periaortic adenopathy, extension of this process to the mediastinum can't be excluded.

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 primary site C772 [Intra-abdominal lymph nodes]. Assign CS extension code 22 [Involvement of spleen plus lymph nodes below diaphragm]. The description from the chest CT is not sufficient to code lymph node involvement above the diaphragm.

 2005
20051092 CS Extension--Kidney: When an incidentally found 5 cm mass discovered on a CT scan during a work-up for colon carcinoma is stated to be consistent with renal cell ca, should the case be staged as localized or unknown when no other information is available related to a work-up for the kidney primary?

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 what is known. In the example above, the tumor size and the extension are known and can be coded. The information is limited, but not completely missing.

Code what you DO know rather than coding nothing. Any metastases from the kidney would have been discovered during the workup of the rectal cancer.

 2005
20051018 CS Lymph Nodes--Breast: Must there be a statement of "moveable" present to code 25 in this field and if a lymph node is not stated to be "fixed" is it presumed to be moveable? Please provide an example in your answer of when to use code 25.

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 word "movable" does not have to be used to assign code 25. A "movable" lymph node is an involved lymph node not described as fixed or matted. The general rule is to code the lesser or lower category, which would be the case if neither movability nor fixation is mentioned. See page C-471 of the 2004 SEER Manual.

Code 25 Example: Involved lymph nodes per lymph node dissection. No mention of fixation or matting. Size of largest met within a lymph node is 4mm.

 2005