Reportability/In situ--Prostate: Has there been a change in reportability for prostatic intraepithelial neoplasia (PIN III) (C619)? The 2018 SEER Manual notes: Collection stopped effective with cases diagnosed 01/01/2001 and later; however, on the casefinding list effective 10/01/2019, code D07.5, carcinoma in situ of prostate, is listed as reportable.
PIN III is not reportable in accordance with the 2018 SEER Manual; however, carcinoma in situ of the prostate is reportable as they represent different histology codes. The casefinding list is used to search for reportable cases and is not the same as a reportable list.
MP/H Rules--Urinary: How many primaries are abstracted when a patient has a May 2000 invasive papillary transitional cell carcinoma of the bladder, a November 2004 invasive papillary transitional cell carcinoma of the right ureter and a May 2007 urothelial carcinoma in situ of both the left and right ureters?
For cases diagnosed 2007 or later:
Using the pre-2007 multiple primary rules, the PTCC of the bladder in 2000 and the invasive TCC of the right ureter in Nov. 2004 would have been abstracted as separate primaries.
Use the 2007 MP/H rules to evaluate the May 2007 diagnosis. Start with rule M3. Stop at rule M8. The May 2007 diagnosis is the same primary.
Rule M4 does not apply because of the 2000 bladder primary. A clarification will be added to M4 to stress that for the urinary rules, any urinary tumor up to the present point in time is counted when applying this rule.
Hematologic Transplant and Endocrine Procedures--Breast: Is a bone marrow transplant first course of cancer-directed therapy for breast cancer? If yes, are time guidelines relating to the first "remission" the same as for those used in leukemia primaries?
For cases diagnosed 1/1/2003 and after: A bone marrow transplant can be first course of therapy for cases in which there has been no progression of disease between the initial therapy (e.g., surgery, radiation, chemotherapy) and the bone marrow transplant. Code Hematologic Transplant and Endocrine Procedures field to 10-12 or 40 (depending on the type of bone marrow transplant performed).
Do not use leukemia treatment time guidelines when coding breast cancer treatment.
EOD-Extension/SEER Summary Stage 2000--Kidney/Eye: What codes are used to represent these fields for simultaneous bilateral Wilms tumor or simultaneous bilateral retinoblastoma?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 85 [Metastasis] and the SEER Summary Stage 2000 field to 7 [Distant] for both types of tumor. Each kidney and each eye are staged separately in the AJCC, 6th ed., but for SEER we would abstract these diagnoses as one case and code the EOD and stage fields to distant to reflect the involvement of both eyes or both kidneys.
First Course Treatment/Surgery of Primary Site--Lung: How is radiofrequency ablation for lung primaries coded?
Assign code 15 [Local tumor destruction, NOS] in the Surgery of Primary Site field. RFA is a technique where a probe placed in or near a tumor sends radio waves into the tumor, causing it to heat up and kill the cancer cells. RFA doesn't fit neatly into code 12 or 13, so we are left with the NOS code.
Reportability--Hematopoietic, NOS: Is a "myeloproliferative disorder" reportable when the pathology report comment states this likely represents the "early/cellular phase of myelofibrosis/myeloid metaplasia" with cytogenetics and PCR pending?
For cases diagnosed prior to 1/1/2010:This case is not yet reportable. The bone marrow diagnosis "myeloproliferative disorder" is not reportable to SEER. It is likely that if this condition progresses, it will eventually be reportable.
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.
Histology (Pre-2007)/Terminology: Are "pattern", "architecture", and "architectural pattern" terms that indicate a majority of tumor?
For tumors diagnosed 2004 to 2006:
The terminology "Architectural pattern: ____________," when used in the final pathology diagnosis, indicates a subtype that can be coded. This type of format in a pathology report is based on a College of American Pathologists (CAP) protocol. Disregard "pattern" and "architecture" when not used in accordance with the CAP protocol. See www.cap.org for cancer protocols.
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.
Behavior/Date of Diagnosis--Lung: If the term "Pancoast tumor, NOS" is malignant by definition, should the date of diagnosis be coded to the date of the clinical diagnosis when the clinical diagnosis is made prior to the histologic confirmation of the malignancy?
Yes, Pancoast tumor is by definition malignant. It is defined as a lung cancer in the uppermost segment of the lung that directly invades into the brachial plexus (nerve bundles) of the neck, causing pain. If a Pancoast tumor was identified on imaging prior to the biopsy, the date of diagnosis should be linked to the Pancoast tumor report.
Histology (Pre-2007)--Breast: What code is used to represent the histology "mucinous carcinoma with Paget disease"?
For tumors diagnosed prior to 2007:
Code the Histology field to 8480/3 [mucinous carcinoma]. This answer assumes the patient presented with a single tumor. There is no combination code that includes these two entities. According to the rules for Coding Complex Morphologic Diagnoses, it would appear that the case should be coded to 8540 [Paget disease] because it is the higher code. However, this combination of histologies represents an exception to that rule. The prognosis for mucinous carcinoma is worse than the prognosis for Paget disease. As a result, it would be more appropriate to the histology to mucinous carcinoma.
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.
EOD-Size of Primary Tumor--Colon: When an adenocarcinoma is stated to be arising in an adenoma and the "tumor size" stated in the final pathologic diagnosis is the same size as the mass described in the gross description, should we assume that the entire polyp has been totally/near totally replaced by tumor and code the tumor size stated in the final path diagnosis?
For cases diagnosed 1998-2003:
Code the EOD-Size of Primary Tumor field as stated by the pathologist in the final pathologic diagnosis. If the size of the tumor is the same as the size of the polyp, assume the polyp was completely replaced by tumor.
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