SEER Inquiry System - Search

Code primary site C449. C449 is the default primary site code for melanoma of unknown primary site. C760 should not be assigned for this case. Updates will be made to SEER*RSA to remove the melanoma histology codes from the Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck schema.

Code primary osteosarcoma of the breast to breast, C500-C509. Not all site and histology combinations can be staged in CS or AJCC. 9180/3 of breast cannot be staged using the CS breast schema. Breast (C500-C509) cannot be staged using the CS soft tissue schema. The same is true for AJCC. You can stage this case using SEER Summary Stage.

Important: Do NOT change the primary site or histology code based on whether or not the case can be CS or AJCC staged. We need to know how many cases are unable to be staged because of their primary site and histology combinations.

Code papillary squamotransitional cell carcinoma (PSCC) as 8120/3 using the 2018 Other Sites Solid Tumor Rules, Rule H11. PSCC is a distinctive subcategory of squamous cell carcinoma of the uterine cervix. WHO Classification of Tumors of Female Reproductive Organs say that squamotransitional cell tumors show papillary architecture with fibrovascular cores lines by multilayered atypical epithelium.

Code papillary carcinoma, tall cell variant with oncocytic features to papillary carcinoma, tall cell (C73.9) (8344/3).  The WHO Classification of Endocrine Organs states that this variant is composed of cells that are as tall as they are wide, and show abundant eosinophilic (oncocytic-like) cytoplasm.  Tall cells must account for greater than or equal to 30% of all tumor cells.

Code neuroendocrine carcinoma, 8246/3. Note 2 under Rule H7 applies.

We are reviewing mixed histologies for the next version of the rules.

Code myoepithelial carcinoma ex pleomorphic adenoma as carcinoma ex pleomorphic adenoma (CXPA) (8941/3) using Head and Neck Solid Tumor Rule H1 as this is a single histology.  The WHO Classification of Head and Neck Tumors, 5th ed., describes CXPA as a rare epithelial and/or myoepithelial malignance arising in association with a primary or recurrent pleomorphic adenoma.  The histologic type of the carcinoma component is usually recorded, in this case, myoepithelial carcinoma.

Code multiplicity counter 04. Count both invasive and in situ tumors.

Multiplicity counter would have been coded 01 in 2008. Add the three in situ tumors diagnosed in 2009 to the first tumor and update multiplicity counter to 04. Make only one update to multiplicity counter. Because the multiplicity counter was updated once, the fifth tumor diagnosed in 2010 does not need to be added.

Code microwave tumor ablation as surgery. For lung, assign code 15.

This question was discussed by the technical advisory group – a small group of representatives from each standard setter which meets periodically. The group agreed on this consensus answer.

Code metronomic chemotherapy as chemotherapy. Metronomic chemotherapy, also referred to as low-dose metronomic (LDM) chemotherapy, is an emerging cancer treatment approach which administers relatively low doses of traditional chemotherapy drugs over a long period of time and without ‘breaks’ in treatment. By using lower doses this method of treatment minimizes the side effects of traditional chemotherapy.

Code low grade B-cell lymphoma with plasmacytic differentiation as 9591/3 (Non-Hodgkin lymphoma, NOS). Plasmacytic differentiation is commonly seen with B-cell neoplasms. If further information identifies a more specific histology, the abstract can be updated to reflect the more specific histology.

In the latest WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues, 4th ed., there is confirmation that DLBCL is a high grade B-cell neoplasm. We will update the SINQ question.