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Report Produced: 02/25/2026 11:03 AM

Report Question ID Question Discussion Answer Year
20031106

Reportability--Appendix: Is an appendiceal carcinoid with one periappendiceal lymph node positive for metastatic carcinoid tumor reportable to SEER? See Discussion.

The patient had an appendectomy followed by a hemicolectomy. No residual carcinoid tumor was identified but there was one lymph node positive for metastatic carcinoid tumor.

Yes, this carcinoid is reportable to SEER. This carcinoid is malignant by virture of the lymph node metastasis. Code the behavior as /3.

2003
20031050 Radiation Sequence with Surgery: How is this field coded when radiation was recommended but it is unknown whether radiation was ever given? Assign code 0 [No radiation and/or cancer-directed surgery]. Code Radiation Sequence with Surgery as 0 when radiation is coded 8. 2003
20031210 Other Cancer-Directed Therapy--Hematopoietic, NOS: Is there a hierarchy for selecting which code to use when a patient receives more than one type of "other treatment"? See Description. Patient was diagnosed with Myelodysplastic Syndrome, probably refractory cytopenia with multilineage dysplasia. Good candidate for investigational studies for transfusion-dependent patients. Patient was enrolled in a high dose vitamin D study. Patient also received transfusions.

SEER has not established a hierarchy of the codes listed under Other Treatment. If the patient receives more than one type of other treatment as the first course of treatment, assign the code that provides the most information about how the patient was treated and use the remarks fields to explain.

Code Other Treatment for the case example above as 2 [Other experimental therapy]. Use the remarks fields to describe the transfusions and vitamin D therapy.

 2003
20031194

Terms of involvement--Lung: Is "intense uptake" described on a PET scan an indication of involvement? See Description.

We are seeing increasing use of PET scans as diagnostic tools for cancer. PET scans use different terminology than the ambiguous terms listed in the EOD manual. Could we please have guidelines for interpreting PET scans?

Example: Patient with right lung cancer. PET scan showed intense uptake in the mediastinum and in the hilum. Can we code "intense uptake" as involvement of mediastinal and hilar lymph nodes?

 Do not interpret "intense uptake" as involvement. Look for a statement of involvement or other terminology, such as "highly suspicious," "strongly suspicious for" malignancy, involvement, etc. 2003
20031042 Histology (Pre-2007): How are the following four histologies coded: 1) Adenocarcinoma with focal mucinous adenocarcinoma; 2) Adenocarcinoma with focal areas of bronchioalveolar adenocarcinoma, 3) Mixed infiltrating duct and focal medullary carcinoma, and 4) Mixed infiltrating duct and focal medullary carcinoma? See Description.

1. How do we code colon: Adenocarcinoma with focal Mucinous adenoca? 8140/3 or 8255/3?

2. A lung lesion with predominant adenoca with focal areas of bronchioalveolar adenoca? 8140/3 or 8255/3?

3. Mixed infiltrating duct carcinoma and medullary ca? 8510/3 or 8255/3?

4. Mixed infil duct ca and focal medulary ca? 8510/3 or 8255/3?

For tumors diagnosed prior to 2007:

1. 8140/3, Adenocarcinoma. Mucinous has a specific rule (see sinq 20010075): Include the mucinous component only if it is 50% or more of the tumor. "Focal" is not a majority term.

2. 8250/3, Bronchiolo-alveolar adenoca. Code the more specific histology.

3. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

4. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of 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.

 2003
20031066 Histology (Pre-2007): Is 8524 [lobular mixed with other carcinoma] or 8490 [signet ring cell carcinoma] used to represent a diagnosis of "infiltrating lobular with signet ring features?"

For tumors diagnosed prior to January 1, 2004:

According to our pathologist consultant, for this specific case, code to 8490 [Signet ring cell carcinoma].

Our pathologist states: "Signet ring cell carcinoma is most often a variant of lobular carcinoma (as it appears to be in this case - it is less frequently a variant of ductal), and I think it's appropriate to code it as such. Coding to lobular would also be ok, though that would lose the special feature of the signet ring cells. I would rather not code to 8524, since it is not really a mix of lobular and something else."

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.

 2003
20031154 Date of Diagnosis/Histology (Pre-2007)/Behavior--Melanoma: How are these fields coded when the first shave biopsy finds "what appears to be the top of a melanoma" and a subsequent shave biopsy finds "features consistent with lentigo maligna?"

For tumors diagnosed prior to 2007:

Evaluate each case using all available information, including all pathology reports. Use the date of the first biopsy because it did identify the melanoma. The second biopsy confirmed the histologic type.

According to WHO's Histological Typing of Skin Tumors, lentigo maligna melanoma is similar to lentigo maligna, but has dermal invasion by atypical melanocytes.

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.

 2003
20031101 Primary Site/Behavior Code/EOD-Extension: How would these fields be coded for "squamous cell carcinoma in situ involving papilloma -- locally aggressive but not technically invasive" found in the sphenoid sinus, soft tissue of the skull base and brain? See Description.

The managing physician has staged this pathologically as T4 N0 M0 squamous cell carcinoma of the ethmoid sinuses. The final pathology report says " Sinus, sphenoid, resection: papillary neoplasm most consistent with inverted papilloma with squamous cell carcinoma in situ, 7 cm in greatest extent, focus of probable superficial invasion (see comment).

Soft tissue, skull base, excision: involved by papillary neoplasm with squamous cell carcinoma in situ (see comment). Brain, extradural, intercranial biopsy: involved by papilloma with squamous cell carcinoma in situ. COMMENT:

This is a predominantly exophytic neoplasm with infolding of the tumor epithelium and in situ extension into submucosal glands. There are only focal areas suspicious for invasive squamous cell carcinoma, with probable invasion (<2mm) in one section....The histologic features are most consistent with an inverted papilloma with carcinoma in situ." When asked to comfirm if the diagnosis were in situ or superficially invasive, the pathologist responded "Squamous cell carcinoma in situ involving a papilloma. Locally aggressive but not technically invasive."

Code site to C31.3 [sphenoid sinus]. Code the site based on the final pathology report diagnosis. In the case example, the site attributed to the managing physician appears to be an error.

Code behavior to 3 [malignant, primary site]. The SEER list of terms meaning involvement may be used to help determine behavior. The terms used by the pathologist are "probable" superficial invasion and "suspicious" for invasive squamous cell carcinoma with "probable" invasion. Interpret as invasive.

For cases diagnosed 1998-2003: Code extension to 70 [Brain] because this tumor involves the brain.

 2003
20031007 EOD Extension--Lung: Do we ignore pericardial effusion seen on a CXR if a subsequent lobectomy reveals only a localized tumor? See discussion. Note 6 in the lung EOD scheme instructs us to assume that a pleural effusion is negative if a resection is done. Does this also apply to a pericardial effusion? For example, if a pericardial effusion is seen on CXR, and a subsequent lobectomy reveals only a localized tumor, should the effusion be ignored? For cases diagnosed 1998-2003: Ignore pericardial effusion which is negative for tumor. Assume that a pericardial effusion is negative if a resection is done and the tumor is pathologically confirmed to be localized. 2003
20031018 EOD-Extension--Head & Neck (Uvula): Is a stage T2 tumor described on the physical exam as an "ulcerated mass occupying uvula midline soft palate, and extending into the right soft palate. It does not extend into the tonsil area nor into the retromolar trigone" coded to 30 [localized, NOS] or 40 [tumor crosses midline]?

For cases diagnosed 1998-2003:

Code EOD-extension to 30 [localized, NOS]. This is mucosal spread (since there is no muscle in the uvula). Soft palate and uvula are handled as a single site, and extension from uvula to soft palate is not addressed in EOD.

 2003