Histology (Pre-2007)/Flag--Pancreas: How is histology coded given that 8046 [non-small cell carcinoma] of the pancreas is not on the SEER Site/Type validation listing?
For tumors diagnosed prior to 2007:
Assign 8046 [non-small cell carcinoma] for "non-small cell carcinoma" of the pancreas. If necessary, override any site/type edits.
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.
Primary Site--Unknown & Ill-defined Site: What is the primary site code for multiple malignant rhabdoid tumors (extra renal) in a newborn infant?
Search for additional information on the location of the primary in this case. A tissue specimen (biopsy) is required for a diagnosis of rhabdoid. Additionaly, there should be scans describing any tumors located in sites other than the biopsy site. If the biopsy site is not assumed to be a metastatic site and is the only location of tumor, code the site of the biopsy as the primary site.
If it is not possible to obtain further information for this case, code the primary site C809 [Unknown primary site].
According to our pathologist consultant, extra-renal rhabdoid tumors have been described in organ sites (liver, GI tract, thyroid, CNS, skin, to name a few) as well as in the soft tissue. Many of the organ site tumors are multiple/multifocal, so multiple tumors in one organ do not necessarily imply metastatic disease and therefore unknown primary site.
CS Extension/CS Mets: For primary sites within the peritoneum (abdominalpelvic walls) such as stomach, colon, does the presence of malignant ascites affect the coding of CS Extension or CS Mets?
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 Collaborative Staging system is governed by site-specific coding rules. Refer to each set of site rules rather than looking for a general answer for all sites in peritoneum. In particular, Ovary and Corpus allow malignant ascites to be coded in CS Extension, but not CS Mets at Dx. For each site, both CS Extension and CS Mets at Dx should be checked for the proper field to code malignant ascites.
CS Extension/CS Mets at Dx--Peritoneum: How are these fields coded for extraovarian peritoneal carcinomas presenting with multiple peritoneal implants? See Discussion.
Patient presented with large omental cake and multiple peritoneal implants including implants on the rectosigmoid serosa and right ovary. Path revealed papillary serous adenocarcinoma consistent with peritoneal primary.
Per AJCC Manual, extraovarian peritoneal carcinoma is usually staged with the ovarian staging classification.
We understand that the CS Manual will eventually be revised to include staging for extraovarian peritoneal primaries. In the meantime, how do we use the existing CS scheme for peritoneum to code these cases?
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 Extension 99 [unknown] and CS Mets at DX 99 [unknown].
The issue has been sent to the CS steering committee for resolution. This answer will be updated when the steering committee provides a resolution.
First Course Treatment--Lymphoma: Should the use of proton pump inhibitors be coded as treatment for lymphoma primaries in patients with H Pylori?
No, do not code proton pump inhibitors as treatment. These are used for gastric acid suppression. Proton pump inhibitors are used to treat symptoms, not the lymphoma itself.
Reportability--Anus: Is a final diagnosis on a pathology report of "squamous cell carcinoma of the anus, NOS" assumed to be a skin of anus primary or a primary of the anus?
Squamous cell carcinoma of the anus is reportable unless known or stated to be skin of anus.
CS Lymph Nodes--Colon: Are positive paracecal lymph nodes for cecal primaries coded to 10 [paracolic] or code 20 [cecal: anterior (prececal), posterior (retrocecal); NOS]?
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 20 [Regional lymph node(s) for specific subsites]. Paracecal means near the cecum. Paracecal lymph nodes are regional nodes for the cecum and not for other colon subsites.
CS Extension--Lung: Can extension be coded to 10 (Tumor confined to one lung) when either an autopsy or a CT scan describes the tumor as a mass of a specified size located in one lobe of the lung without any description of extension and no available TNM provided? See Discussion.
Example 1: Lung primary within the right lower lobe described clinically as greater than 3 cm on scan but was found to be 3 cm at autopsy.
Example 2: CT scan February shows 2 cm mass in RUL.
In both cases, the only tumor description was the size of tumor without any information regarding extension.
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, assign code 10 [Tumor confined to one lung] for a mass in one lobe when none of the descriptions in codes 11 to 80 are documented.
CS Eval--Prostate: How is CS Ts/Ext Eval to be coded for a clinically inapparent prostate cancer that is treated with Lupron and a subsequent prostatectomy? See Discussion.
Patient diagnosed with prostate cancer on biopsy for elevated PSA, CS extension code 15. Patient then receives 4 courses of Lupron. Subsequent radical prostatectomy shows bilateral lobe involvement with capsule invasion, SSF 3 pathologic extension code 032.
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 TS/Ext Eval 6 [surgical resection performed with pre-surgical systemic treatment, tumor size/ext based on path evidence]. For prostate, CS TS/Ext eval must reflect coding of CS extension and SSF 3. In this case, SSF 3 code 032 is based on the prostatectomy information which occurred after systemic treatment.
Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: For cases diagnosed in 2005, if a specimen contains an invasive 4.5 cm lobular carcinoma of the right breast and also has a tiny focus of intraepidermal tumors cells [Paget disease of nipple], how many cases should be abstracted and how should the histology field(s) be coded?
For tumors diagnosed prior to 2007:
There are two primaries in this example:
1. Invasive lobular carcinoma [8520/3]
2. In situ Paget disease of nipple [8540/2].
There is no combination code for lobular carcinoma and Paget disease.
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.
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