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For tumors diagnosed prior to 2007:

Assign code 8001/3 [Tumor cells, malignant] when the only information available is a cytology report stating "malignant cells."

Assign code 8000/3 [Neoplasm, malignant] when then only information available is a CT report stating "probable malignancy."

See ICD-O-3 page 27 for an explanation of "cancer" [8000] and "carcinoma" [8010].

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.

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 "small isolated tumor emboli" in the pericapsular lymphatics detected by H&E that are less than 0.2 mm as 05 [Regional lymph node(s) with ITC's detected on routine H & E stains].

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 tumor size as 080 (8cm). Code the largest pretreatment size recorded when there is preoperative systemic treatment.

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.

For tumors diagnosed prior to 2007:

Regression does not affect CS staging for cutaneous melanoma. "Malignant melanoma, regressing" [8723] is coded only when it is the final diagnosis. Do not use code 8723 for the examples above.

According to our pathologist consultant:

Melanoma can occasionally undergo "spontaneous" regression -- the tumor can become smaller, and in some cases even disappear. This phenomenon is likely due to an increased immune response on the part of the "host" (person with the melanoma). This is noted occasionally in patients with metastatic disease which gets smaller, or even disappears. We think this is also what has happened in patients who get diagnosed with metastatic melanoma, say in a lymph node, but have no primary tumor, though sometimes give a history of a skin lesion which came and then went away, or a skin lesion which was not submitted for pathological examination. In addition, we (pathologists) occasionally see biopsies which have melanoma as well as the presence of the immune reaction to it, and once in a while, the immune reaction with little or no evidence of residual melanoma.

The College of American Pathologists says that regression of 75% or more of the melanoma carries an adverse prognosis.

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.

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 Lymph Nodes as negative [00]. The positive stain for pancytokeratin is contradicted by the statement "malignant cells are not identified." See also sinq 20010055.

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.

Clinical size can be coded when the patient has had surgery. For the case above, code the tumor size as 015 [1.5 cm] using the clinical information. The CS Tumor Size/Extent Eval field refers to both tumor size and extension. In this case, record the eval field as 0 or 1 (which ever is appropriate). The tumor size sets the T category unless the resection shows skin or chest wall or dermal lymphatic involvement.

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 Mets Eval for the example above 3 [path exam of metastatic tissue] assuming there has been no pre-treatment. Positive cytology is required for confirmation of pleural effusion for an ovarian primary.

For hospital A, follow the instructions in the 2004 SEER Manual on page 5, #4. For hospital B, the case is not reportable.

The diagnosis date is the date of first excision. Code the breast excision from Hospital A as surgery, first course treatment. The mastectomy was not part of first course treatment.