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| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20021008 | Surgery of Primary Site/Surgical Procedure of Other Site--Bladder: What codes are used to represent these fields for a deeply invasive bladder primary treated initially with a TURP (for suspected prostate extension that turns out to be pathologically negative) and a TURB that is subsequently treated with a cystoprostatectomy? | For cases diagnosed 1/1/2003 and after, code: 1. Surgery of Primary Site field to 60 [Radical cystectomy (male only)] because the cystoprostatectomy was the most extensive (definitive) surgery performed to the primary site. 2. Surgical Procedure of Other Site to 2 [Non-primary surgical procedure to other regional sites] based on the TURP. |
Bladder | Surgery of Primary Site | 2002 | |
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20071116 | Behavior--Bladder: What behavior code is used for a TURB path specimen diagnosis of "non-invasive urothelial carcinoma, no muscle found, depth of invasion cannot be assessed" when the clinician stages the case as Ta? See Discussion. | The SEER site specific coding module for bladder says, "If the only surgery performed is a TURB and if it is documented that depth of invasion cannot be measured because there is no muscle in the specimen, code the behavior as malignant and not in situ." | Assign behavior code 2 [in situ] based on the physician's stage Ta. When no other information is available and the TNM designation is not available, use the instructions on page C-844 in Appendix C of the 2007 SEER manual as a default. |
Bladder | Behavior | 2007 |
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20000846 | EOD-Extension/EOD-Lymph Nodes--Bladder: Are "perivesical nodules" coded in the EOD-Lymph Nodes field or are they discontinuous extension and coded in the EOD-Extension field? |
For cases diagnosed 1998-2003: Code "perivesical nodules" in the EOD-Lymph Nodes field as involvement of regional lymph nodes. Each gross nodule of metastatic carcinoma in the fat surrounding an organ is counted as one positive regional lymph node. |
Bladder | N/A | 2000 | |
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20140030 | MP/H Rules/Multiple primaries--Bladder: Is this a single primary or multiple primaries? Transurethral resection of the bladder identifies two bladder tumors. Pathology states one is high grade papillary carcinoma (8130/3) and the other is lymphoepithelioma-like urothelial carcinoma (8082/3). Lymphoepithelioma-like is listed as a urothelial type in Table 1 but rule M6 does not include it in the list of histologies and we are not told to refer to Table 1. M8 refers to Table 1 but does not include multiple bladder tumors (C67_). Specify which rule would apply and why. |
Rule M9 applies to this case. Abstract two primaries. M6 does not apply to this case because code 8082 is not one of the applicable histology codes for M6. This situation will be reviewed as we prepare the next version of the rules. |
Bladder | N/A | 2014 | |
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20110068 | MP/H Rules/Multiple primaries--Bladder: Which multiple primary rule is used to determine the number of primaries to accession when a patient has a papillary transitional cell carcinoma of the bladder diagnosed in 2009 followed by a high grade invasive urothelial carcinoma with neuroendocrine features per immunohistochemistry diagnosed in 2010? See Discussion. | A patient has papillary transitional cell carcinoma of the bladder in March of 2009. In June of 2010 the patient has another TURBT that demonstrates a flat in situ and invasive high grade urothelial carcinoma. The path addendum indicates, "Genzyme IHC show results consistent with high grade invasive urothelial carcinoma with neuroendocrine features." Two months later a liver biopsy shows poorly differentiated malignant tumor. The path addendum indicates, "Genzyme IHC results show metastatic poorly differentiated carcinoma with neuroendocrine features, favor bladder primary."
Is the latter a second bladder primary with histology code 8246/3 [neuroendocrine carcinoma]?
NOTE: Neuroendocrine is not listed as an urothelial tumor in Table 1 of MP/H Rules. |
Use the Multiple Primary and Histology Coding Rules Manual for cases diagnosed 2007 or later to determine the number of primaries. This is a single primary. The 2010 diagnosis is urothelial carcinoma. The presence of "neuroendocrine features" does not change the histologic category.
The steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules manual. Once in the manual, locate the Urinary MP rules under one of the three formats (i.e., flowchart, matrix or text). The rules are intended to be reviewed in consecutive order within the module. You stop at the first rule that applies to the case you are processing.
Start at the MULTIPLE TUMORS module start at rule M3.
. Bladder tumors with any combination of transitional cell carcinoma and papillary transitional carcinoma are a single primary. |
Bladder | N/A | 2011 |
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20031080 | Behavior Code/EOD-Extension--Bladder: How are these fields coded for a bladder tumor in which the pathologist states, "there is no definite invasion identified" but the urologist states the case as T1? See Description. | Patient presents with four bladder tumors, described as "each measuring close to 2 cm." A specimen was taken of only one of the tumors. The tops of the tumors were fulgurated, then vaporized methodically. No obvious tumor or residual was noted on re-inspection. Pathology revealed papillary urothelial carcinoma, high grade, with no definite invasion identified. Small segments of muscularis propria were present. A comment read..."it is difficult to determine if lamina propria invasion is present due to marked necrosis and tissue fragmentation." Urologist staged this as AJCC cT2a, but based on the pathology findings changed it to cT1. The urologist insists this is invasive. |
For cases diagnosed 1998-2003: Because of the damage to the specimen from cautery and the insistence of the urologist that the tumor was invasive, code extension for this case to 15 based on the physician's TNM category of T1.
A T1 is invasive--code the behavior /3. The urologist is confident it is invasive, and will likely treat the patient accordingly. |
Bladder | Behavior | 2003 |
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20140016 | MP/H Rules/Histology--Bladder: What is the correct histology code for this situation? See discussion. | Patient has 2 bladder tumors, both invasive -- one is transitional cell carcinoma (8120/3) and the other is papillary TCC (8130/3). They have the same extent of disease, both involve the lamina propria. Is this 8120, because of the Note under rule H11 or is this 8130 because under rule H12, it says 'papillary carcinoma and transitional cell carcinoma'? If so, what is the meaning of the note under rule H11? | Rule H12 applies, code to 8130. The note under H11 is intended to explain the order of the rules; that is, why the rule to code papillary transitional/urothelial cell carcinoma (H12) follows the rule to code transitional/urothelial cell carcinoma (H11). |
Bladder | Histology | 2014 |
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20200043 | Histology/Behavior--Bladder: Is the behavior of a bladder tumor with low-grade papillary urothelial carcinoma /2 or /3? See Discussion. |
Transurethral resection: Microscopic Diagnosis: Bladder, transurethral resection: Low-grade papillary urothelial carcinoma Gross Description: Received in formalin labeled with the patient's name and bladder tumor is a 3.0 x 2.0 1.0 cm aggregate of friable tan tissue biopsies. The specimen is submitted in toto, cassettes This is all the information there is on this path report. Extent of Disease (EOD) instructions state inferred description of noninvasive: No statement of invasion (microscopic description present) SEER 2018 Appendix C Bladder Coding Guidelines state code behavior 3 if the only surgery performed is a transurethral resection of the bladder (TURB) documenting that depth of invasion cannot be measured because there is no muscle in the specimen OR the pathology report does not mention whether the submucosa is free of tumor or has been invaded by tumor. |
For cases diagnosed 2021 or later Code the behavior as in situ (/2) when the diagnosis is low grade urothelial carcinoma and there is no information regarding invasion. The SEER Manual Appendix C Bladder Coding Guidelines revision reflects this change. No changes have been made to EOD at this time. The guidelines have been updated as follows. Low grade urothelial carcinoma with no other information: Code to /2. High grade urothelial carcinoma with no other information: Code to /3. For cases diagnosed prior to 2021 Code the behavior as malignant (/3) for a bladder tumor with low-grade papillary urothelial carcinoma. |
Bladder | Behavior, Histology | 2020 |
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20041092 | CS Extension--Bladder: How would the following statements be coded for bladder extension -- Code 03 [inferred description of non-invasion] vs code 15 [invasive confined to subepithelial connective tissue]. See Discussion. | 1) no smooth muscle invasion 2) no muscle invasion 3) without muscle invasion 4) no invasion of muscularis propria |
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 cases diagnosed in 2004 and later code CS extension: 1) no smooth muscle invasion -- 15 2) no muscle invasion -- 15 3) without muscle invasion -- 15 4) no invasion of muscularis propria -- 03 |
Bladder | N/A | 2004 |
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20010073 | EOD-Extension--Bladder: Both papillary transitional cell ca in situ and sessile (flat) transitional cell ca in situ are diagnosed simultaneously in the bladder. We code the higher histology (8130/2). For extension, do we use the code that corresponds to the histology (01), or to the higher extension code (06)? | For cases diagnosed between 1998-2003:
Code the EOD-Extension field to 06 [sessile (flat) (solid) carcinoma in situ], the higher extension code. |
Bladder | N/A | 2001 |
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