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| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20031082 | EOD-Size of Primary Tumor: Pathologist states that the size of the tumor is difficult to measure but is greater than 3cm but less than 5cm. How would we code the tumor size? | For cases diagnosed 1998-2003:
Code the largest dimension mentioned, since that is the standard rule for coding tumor size. Keep in mind that tumor size is not used in analysis for certain sites such as stomach, colon & rectum, ovary, prostate, and urinary bladder. Tumor size is important for analysis for certain sites such as lung, bone, breast, and kidney. |
N/A | N/A | 2003 | |
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20031125 | Histology/Reportability/Behavior Code--Testis: Is a mature teratoma that is metastatic to lymph nodes reportable? See Description. |
Pathology report states, "Histologic sections reveal lymph node metastases, consisting predominantly of mature teratoma. In addition, there are cells scattered through the fibrous stroma which exhibit mild cytologic atypia but have low N:C ratios. The largest metastasis grossly measures 10cm. In addition extracapsular extension is identified. Diagnosis: Lymph Nodes--Metastatic Testicular Carcinoma Involving Multiple Lymph Nodes." The morphology code for mature teratoma is 9080/0. The pathologist does not classify this as an immature teratoma (9080/3). Is this reportable? |
Yes, this metastatic teratoma is reportable. This is a malignant teratoma by virtue of the lymph node metastases. Code the histology as 9080/3 [Teratoma, malignant, NOS]. Primary site is testis [C62_]. |
N/A | Behavior, Histology | 2003 |
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20091017 | Primary site--Esophagus: How is primary site coded for a tumor arising in a segment of the esophagus that was reconstructed using a segment of the colon? See Discussion. |
A patient had a ruptured esophagus 25 years ago and had a segment of colon removed and transplanted to serve as esophagus. In 2007, the patient was diagnosed with carcinoma in a polyp by endoscopic biopsy of the transplanted 'esophagus'. What is the primary site code? Is this the same site schema to be used for Collaborative staging and surgery coding? |
Code the primary site esophagus, NOS [C159]. Use the surgery codes and collaborative staging schema for esophagus. Document the unusual nature of this case in text fields. |
N/A | Primary site | 2009 |
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20091018 | MP/H Rules/Multiple Primaries/CS Extension: How many primaries are to be accessioned when tumors are present bilaterally in the pleura and fallopian tubes? See Discussion. | For both pleura and fallopian tube, the MP/H rules indicate that bilateral involvement of these sites should be coded as multiple primaries. However, both of these sites have CS extension codes that classify the contralateral disease as regional extension. Is a case described as a left sided pleural mesothelioma that has right sided pleural disease coded as one or two primaries? How is CS coded? |
For cases diagnosed 2007 or later: For a pleural or fallopian tube primary, if there is tumor(s) on the left and separate tumor(s) on the right and neither is stated to be metastatic from the other, abstract as multiple primaries according to rule M8 for other sites. If both sides are involved, but there is only one tumor, rule M2 for other sites applies and this is a single primary. Code each primary separately in CS. |
N/A | N/A | 2009 |
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20091019 | MP/H Rules/Histology--Hematopoietic, NOS: Can a diagnosis of multiple myeloma be made if a bone marrow biopsy is negative? See Discussion. | Patient with large mass nasal cavity. Biopsy shows plasmacytoma. Fine needle aspiration of the acetabulum is consistent with multiple myeloma. Skeletal survey shows multiple lytic lesions. Bone marrow biopsy is negative for myeloma. In light of negative bone marrow biopsy can this case be coded as multiple myeloma? | For cases diagnosed prior to 1/1/2010:Code this case as multiple myeloma. The fine needle aspiration of the acetabulum is a biopsy of bone marrow. According to our pathologist consultant, the positive bone marrow biopsy (acetabulum) and the multiple lytic bone lesions confirm multiple myeloma. The negative bone marrow biopsy is likely due to an insufficient sample. For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
N/A | Histology | 2009 |
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20091024 | MP/H Rules/Multiple primaries--Urinary: Are diagnoses in bladder, ureter, renal pelvis, and other urinary made prior to 2007 used in determining multiple primaries? See Discussion. |
Per the General Information for MPH, Rule #3, the rules are effective for cases diagnosed January 1, 2007 and after. Do not use these rules to abstract cases diagnosed prior to January 1, 2007. Example: Is a 2006 diagnosis of a renal pelvis primary with the histology 8130/3 and a 2007 diagnosis of a bladder primary with histology 8130/3 "multiple tumors" or is the bladder tumor a new primary because it is a single tumor at the time of diagnosis in 2007? |
For cases diagnosed 2007 or later: Use the 2007 MP/H rules for urinary sites to assess tumors diagnosed in 2007 or later. For the example above, use the 2007 rules to determine whether or not the bladder tumor diagnosed in 2007 is a new primary. Use the Multiple Tumors module when comparing a 2007 or later diagnosis to an earlier diagnosis. Start with rule M3. Stop at rule M8. The 2007 bladder urothelial tumor is not a new primary since there is an existing 2006 renal pelvis urothelial primary. |
N/A | N/A | 2009 |
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20031063 | Date of Diagnosis: When the clinical information on a scan indicates a history of cancer, how do you code the month and/or year of diagnosis given these terms: "early in year," "late in year," "2-3 months ago," "7 months ago," "new diagnosis." See Description. | Case 1. Diagnosed with CLL in late 1996. Assumptions: Code the term "late" in the year to December. Date of diagnosis would be coded to December 1996.
Case 2. Diagnosed with CLL in early 1997. Assumptions: Code the term "early" in the year to January. Date of diagnosis would be coded to January 1997.
Case 3. Admitted July 2000. Per H & P, patient was diagnosed with prostate cancer 2-3 years ago. Assumptions: Select the higher number in the range (in this case 3 years) and subtract 3 years from date of admit to calculate year of diagnosis. Code diagnosis month to the month patient was admitted. Diagnosis date would be coded July 1997.
Case 4. Admitted in October 2001. H&P states that colon cancer was diagnosed 7 months ago. Assumptions: Subtract 7 months from date of admit. Code date of diagnosis to March 2001.
Case 5. Admitted in December 2001. Per H&P, patient has CLL, presumably a new diagnosis. Assumptions: Assume the H&P statement of "new" to be equivalent to "recent" and code date of diagnosis to date patient was admitted. In this case, date of diagnosis would be coded to December 2001.
Case 6. Admitted for radical prostatectomy for prostate cancer in March 2001. H&P states that his PSA was 5 in November 2000 and in January 2001, PSA was 5.3. Biopsies showed adenocarcinoma. Assumptions: Assume the biopsy was done the same month as the January 2001 increased PSA. Date of diagnosis would be coded to January 2001.
Case 7. Outpatient bone scan done December 2001. Clinical history on the scan stated patient has history of prostate cancer. The physician was queried about date of diagnosis. Per the physician response, patient was diagnosed in 2001. Assumptions: Assume the bone scan was part of the initial work-up for prostate cancer and estimate the date of diagnosis to December 2001. |
SEER agrees that these are reasonable assumptions based on the information provided.
Estimate the month and year of diagnosis using the available information. If the information is not sufficient to make an estimation on the month, code the month of diagnosis as "99." Avoid coding "unknown" for the year of diagnosis. |
N/A | Date of diagnosis | 2003 |
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20000269 | Multiple Primaries (Pre-2007): Is an in situ tumor followed by another in situ tumor in the same location a new primary? See discussion. |
Example: Six months after an in situ lesion was excised from the buccal mucosa, another in situ lesion was excised from the same area of the buccal mucosa with no mention of it being recurrent. |
For tumors diagnosed prior to 2007: Code as a second primary if the second in situ tumor occurred more than 2 months after the first, and it is not referred to as recurrent by the clinician or pathologist. There are no special rules for determining the number of primaries when an in situ lesion follows an in situ. 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. |
N/A | N/A | 2000 |
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20081034 | 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. | N/A | Race, ethnicity | 2008 |
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20031054 | Grade, Differentiation: Is grade always coded to 4 for a diagnosis of Ewing's sarcoma? | Do not code the ICD-O-3 grade for Ewing sarcoma unless documented in the record. In the TNM system, grade is required to place Ewing sarcoma into a stage group. For TNM staging purposes, Ewing sarcoma is classified as G4. Do not apply TNM rules to ICD-O coding. |
N/A | N/A | 2003 |
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