Ambiguous terminology/Reportability--Thyroid: Should a thyroid case be accessioned based only on a cytology that is consistent with papillary carcinoma? See Discussion.
Instructions in the 2007 SPCSM state that we are not to accession a case based only on a suspicious cytology. Does this rule apply only to the term "suspicious" or does it apply to all ambiguous terms? Example: FNA of thyroid nodule is consistent with papillary carcinoma.
Do not accession the case if the cytology is the only information in the medical record. The phrase "Do not accession a case based only on suspicious cytology" means that the cytology is the only information in the record. If there is other information that supports the suspicion of cancer (radiology reports, physician statements, surgery), then accession the case. The phrase "suspicious cytology" includes all of the ambiguous terms.
Race, Ethnicity/Spanish Surname or Origin: Which Spanish Surname List (from 1980 census or 1990 census) would SEER prefer us to use to code 7 in Spanish Surname or Origin? See Discussion.
In the SEER coding manual, it refers to "a list of Hispanic/Spanish names" (5e), but does not specify which one to use. Again, for the Computed Ethnicity field, which Spanish Surname List does SEER prefer us to use?
Determine which list is better suited for your geographic area. If the 1990 list is used, determine the probability cut-off that seems most reasonable for your geographic area.
2004 SEER Manual Errata/Grade--Colon/Bones: Is the term "pleomorphic" used to code tumor grade to 3 for selected primaries?
Delete the row containing the word "pleomorphic" from the tables on pages 93, C-219 and C-411. This correction will be included in the next set of replacement pages for the 2004 SEER manual.
2004 SEER Manual Errata/Surgery of Primary Site--Lymphoma: Item 9.a on page 178 is incorrect. Do not assign surgery code 98 to lymphoma, primary in lymph nodes. See Appendix C, page C-707 for Lymphoma (primary in lymph nodes) surgery codes.
Delete item 9. a. i. ii. and iii. on page 178 of the 2004 SEER Manual. This correction will be included in the next errata.
Grade, Differentiation--Bladder: Some pathologists use a two component grade system for bladder carcinomas - either low grade or high grade. Should we continue to code these per SEER rules as grades 2 [low grade] and 4 [high grade]? See discussion.
The AFIP website states that this low grade classification corresponds to grade 1/3, while the high grade corresponds to both grade 2/3 and grade 3/3. Using the 3-grade conversion, this would also classify the low grade as grade 2, but would leave the high grade as a toss-up between grade 3 and grade 4.
Continue to code Grade, Differentiation as specified in the SEER Program Code Manual: "Low grade" is coded to 2 and "high grade" is coded to 4.
Surgery of Primary Site--Skin: For skin primaries diagnosed 1998-2002, what is the difference between code 40 [Wide excision or re-excision of lesion or minor (local) amputation, NOS] and 50 [Radical excision of a lesion, NOS]?
Codes 40 and 50 are not in the scheme for 2003 forward. See history for coding cases diagnosed 1998-2002.
EOD-Size of Primary Tumor: Can size be coded from a needle bx that removes all of the invasive tumor and just leaves a "focus of in situ"? See Description.
For example: needle bx diagnosis is "tiny focus of tissue highly suspicious for tubular ca." The lumpectomy path states "single focus of low grade DCIS, no residual ductal ca." Can size be coded 001?
Code tumor size to 001 [Microscopic focus or foci only] for the invasive component. Code the tumor size 990 for cases diagnosed in 2004 and forward. Disregard the microscopic tumor found at further resection.
Immunotherapy/Radiation Therapy: Is I-131 labeled immunoglobulin coded as immunotherapy or radiation therapy?
Code treatment with I-131 labeled immunoglobulin as radiotherapy. The primary action is radiotherapeutic. Radioimmunotherapy (RIT) uses antibodies to deliver the radiotherapy to the site of the tumor.
Primary site--Melanoma: Should melanoma of the nipple be coded to C50.0 [Nipple] or C44.5 [Skin of the trunk]?
Code to C44.5 [skin of trunk]. External melanoma is an epidermal malignancy, beginning in melanocytes in the basal layer of the epidermis. C50.0 excludes skin of breast.
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