| Report | Question ID | Question | Discussion | Answer | Year |
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20061145 | Histology (Pre-2007): Is an intra-abdominal mass with the histology of "squamous cell carcinoma arising in a dermoid cyst" coded to 8070/3 [Squamous cell carcinoma] or 9084/3 [Dermoid cyst with malignant transformation]? | For tumors diagnosed prior to 2007:
Code histology to 9084/3 [Dermoid cyst with malignant transformation] per the ICD-O-3. Dermoid cysts may contain a malignant component of a type typically encountered in other organs and tissues.
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. |
2006 | |
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20061138 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How many primaries are to be abstracted and how is the histology field(s) coded when a nipple biopsy demonstrates Paget disease and a separate biopsy in the same breast demonstrates inflammatory breast carcinoma? See Discussion. | Should Paget disease be coded as the histology because it has a higher histology code than inflammatory carcinoma? | For tumors diagnosed prior to 2007:
Abstract the inflammatory carcinoma as one primary and the Paget disease as a separate primary. The first three digits of the histology codes for these histologies are different (8530 and 8540). Therefore, these are separate primaries.
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. |
2006 |
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20061032 | Behavior--Head & Neck: Should the SEER IF_Morph_3 edit be modified because it does not allow a behavior code 2 with histology 8941 [carcinoma in a pleomorphic adenoma] for a parotid primary? | Code the behavior as 2 and over-ride the edit. The edit is there to flag unusual combinations. Once you have verified that the behavior is coded correctly, over-ride the edit. The surgeon stage of T2 is based on size of tumor, the TIS is based on behavior. Code according to pathologically confirmed TIS. |
2006 | |
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20061104 | Reportability/Behavior--Hematopoietic, NOS: Is a "myelodysplastic/myeloproliferative disease, unclassifiable" coded to 9975 with a behavior code of 3 as indicated in the WHO blue book on "Tumours of Haematopoietic and Lymphoid Tissues" or is it not abstracted because it has a behavior code of 1 which means the case is not reportable? | For cases diagnosed prior to 1/1/2010:Code MDS/MPD U to 9975/3 [Myelodysplastic/myeloproliferative disease, unclassifiable]. Change the behavior code to /3 according to ICD-O-3 Rule F. The case is reportable. The WHO book is more recent and gives a specific code for this new hybrid category of the WHO/REAL classification.
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. |
2006 | |
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20061063 | CS Extension--Lung: Do notes 6A and 6B in the 2004 SEER manual offer conflicting instruction for determining the significance of pleural effusion for this primary site? See Discussion. | 1. Is note B to be used to modify or change what note A states? Does note B state -- If a pleural fluid bx(s) is negative; but the fluid is bloody and/or is an exudate, and clinical judgment indicates the effusion is related to tumor -- use code 72? If a pleural effusion is biopsied should the pathology report state the color of the pleural fluid or is an exudate? (Training issue)
2. Do the following clinical findings impact the clinical evaluation of involvement for a pleural effusion? If yes, why? (Training issue(s)) a. Heart problems? b. The location of the pleural effusion? i. Bilateral pleural effusion is noted; tumor in Rt or Lt lung only? ii. Bilateral pleural effusion is noted; tumor in both lungs? iii. Pleural effusion is noted on the opposite side from the tumor? iv. Pleural effusion is on same side as the tumor?
SUPPORTING CS MANUAL DOCUMENTATION Note 6: Pleural Effusion. A. Note from SEER manual: Ignore pleural effusion that is negative for tumor. Assume that a pleural effusion is negative if a resection is done. B. Note from AJCC manual: Most pleural effusions associated with lung cancers are due to tumor. However, there are a few patients in whom multiple cytopathologic examinations of pleural fluid are negative for tumor. In these cases, fluid is non-bloody and is not an exudate. When these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging element and the patient should be staged T1, or T2, or T3. |
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. 1. Note B does not modify or change note A. Note B is explaining when an effusion should not be used to determine the stage. Pleural effusions are evaluated by cytology, not biopsy. 2. If relevant, the clinician should document the fact in the medical record. Heart problems can cause non-malignant pleural effusions (that are disregarded for staging). Pleural effusion will almost always be around the lower lobes due to gravity, but may envelop an entire lung. Pleural effusions can be unilateral or bilateral regardless of the location of the tumor, but are usually on the side where the tumor is. |
2006 |
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20061014 | Surgery of Primary Site--Lung: Is this field coded to 30 [Resection of lobe or lobectomy] or 33 [Lobectomy with mediastinal lymph node dissection] when a lobectomy specimen includes 2 AP window lymph nodes? See Discussion. | LUL lobectomy: 1.7cm apical tumor, DX=mod well diff subpleural SCC, with involvement of pleural surface. 3 peribronchial LN neg and 2 AP window LNs neg. Stage T2N0. 1. No lymph node dissection or sampling was stated to be done 2. The lobectomy specimen contained the LNs 3. Scope of regional LN surgery is coded Would the surgery to primary site code 30 or 33? |
Code surgery of primary site to 30 [Resection of lobe or lobectomy]. According to the information provided, there was no lymph node dissection in this case. The 2 AP window nodes were obtained as part of the lobectomy specimen. | 2006 |
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20061092 | CS Tumor Size--Breast: Should this field be coded to 999 [Unknown] or 008 [0.8 cm tumor] when the tumor size is not provided on a stereomammotomy biopsy for an in situ malignancy and a subsequent excision demonstrates 0.8 cm tumor of residual in situ disease? | 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 008 [0.8cm]. A mammotomy specimen is very small, so for this case, the residual tumor size is quite accurate. Size is not a critical data element for in situ breast cancer. |
2006 | |
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20061071 | CS Extension--Lymphoma: In the absence of physician staging, is an "enlarged" spleen seen on CT coded as involvement of the spleen for lymphoma 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. Do not code spleen involvement when the only evidence is an enlarged spleen. When imaging is the only diagnostic tool (no biopsy or splenectomy), spleen involvement is based on the presence of nodules and not on enlargement. Splenic enlargement alone (by physical exam or imaging) is insufficient to support involvement of spleen. |
2006 | |
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20061111 | Reportability/Behavior--Skin: Is an "atypical fibroxanthoma (superficial malignant fibrous histiocytoma)" with an ICDO-3 histology code of 8830 reportable with a behavior code of 3 or is it nonreportable with a behavior code of 1? |
Yes, "atypical fibroxanthoma (superficial malignant fibrous histiocytoma)" is reportable. The information in parentheses provides more detail and confirms a reportable malignancy. |
2006 | |
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20061023 | Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses? | No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3. | 2006 |
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