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For tumors diagnosed prior to 2007:

Assign histology code 8210 [adenocarcinoma in a tubular adenoma] and behavior code 2 [in situ]. "In situ" is specified by the pathologist.

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.

For tumors diagnosed prior to 2007:

Code as one primary. Code the Histology field to 8263/3 [Adenocarcinoma in tubulovillous adenoma].

Count as a single primary and code the more specific term when simultaneous lesions are present and one lesion is an "NOS" term and the other is a more specific term. "Polyp" is an NOS term. Adenoma is an associated term, but is more specific (Tubulovillous adenoma is more specific than "polyp").

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.

Code treatment with Iressa as chemotherapy.

Iressa is an epidermal growth factor inhibitor. While it doesn't kill cells directly, it damages the cell reproduction process. We classify it as a chemotherapy agent.

For cases diagnosed 1998-2003:

1) You may add "Imaging" to the size priority list for all EOD schemes that currently do not include it. Prioritize it just above the physical exam for these sites.

2) You may use the information from any imaging technique to code tumor size, even for those sites such as breast and bladder where specific imaging tests are mentioned.

For cases diagnosed prior to 1/1/2010:T-cell large granular lymphocytic leukemia [9831] is a very indolent form of leukemia. It was assigned a behavior code of 1 by the editors of ICD-O-3 (as noted on pages 102, 147, 156 160-162, and 167 of the ICD-O-3 manual). The table on page 17 is the World Health Organization list of hematopoietic and lymphoid tumors. WHO recognizes TCLGLL as a malignancy. The disease is infrequently symptomatic enough to be diagnosed. However, when any of the terms listed with code 9831 are described as malignant or aggressive, report to SEER as a malignancy with a behavior code of /3.

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.

Code the EOD-Size of Primary Tumor field to 004 [4 mm]. Code the diameter dimension in the EOD-Size of Primary Tumor field and the depth dimension iin the EOD-Extension field. Code the largest number associated if a range is provided for the diameter of the invasive tumor.

If the size of the diameter had not been mentioned, the EOD-Size of Primary Tumor field would have been coded to 001 [microscopic focus or foci only], which ignores the size associated with the depth dimension of the tumor.

For cases diagnosed 1998-2003:

Code EOD extension as 30 [Localized, NOS] and laterality as 4 [Bilateral involvement]. The next update to the SEER edits will allow this combination.

For tumors diagnosed prior to 2007:

Code the Histology field to 9100/3 [Choriocarcinoma]. Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma.

Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only] based on the information above. However, if imaging, direct visualization, or another method identified the pulmonary metastases, then code the Diagnostic Confirmation accordingly.

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.

For cases diagnosed January 2004 and forward:

1) Grade 4. High grade is coded 4. Code the grade stated in the final diagnosis.

2) Grade 3. Grade 1-2/3 is coded 3. Use the three-grade conversion table in the 2004 SEER manual.

3) Grade 4. Grade 3 of 3 is coded 4. Use the three-grade conversion table in the 2004 SEER manual.

4) Grade 3. "Grade 3 out of 4" is coded 3 and is more precise than "high grade."

This answer pertains to cases prior to 2014. For cases diagnosed 2014 and forward, see http://seer.cancer.gov/tools/grade/

Do not use FIGO grade to code differentiation.

FIGO grade is something completely different from FIGO stage. FIGO stage is used to code EOD. FIGO grade is based on the percentage of non-squamous (i.e., solid) portions of the tumor and corresponds roughly to a three grade differentiation system: grade I, well differentiated (=<5% solid component); grade II, moderately differentiated (>5 - 50% solid); and grade III, poorly differentiated (> 50% solid). SEER is evaluating whether the ICD-O-3 6th digit differentiation codes (four grade categories) accurately represent the FIGO grade. For the time being, do not code FIGO grade.

For a diagnosis that includes commonly used differentiation term with a FIGO grade, such as "Moderately differentiated, FIGO grade II," disregard the FIGO grade and code the Grade, Differentiation field according to the term "Moderately differentiated."