Histology--Heme & Lymphoid Neoplasms: Should the 1995 diagnosis be changed to plasmacytoma? A 1995 case on the central registry database indicates that MRI and bone surveys revealed a pubic ramus lesion that was biopsied. There are no other bone lesions. A bone marrow biopsy was negative. The pathologist's diagnosis at that time was "Plasma Cell Myeloma". In 2013 there was a positive bone marrow biopsy and a diagnosis of Plasma Cell Myeloma. In 2013, a history of "sequential plasmacytomas since 1995" was mentioned. Since the 1995 diagnosis was only a solitary bone lesion with no marrow involvement, it certainly seems to fit a diagnosis of plasmacytoma better than myeloma.
Do not change the 1995 diagnosis in this case. It is best to code the histology according to information from the time of the diagnosis. Using information obtained many years later is less reliable.
SEER Manual/Reportability--Brain and CNS: Is microadenoma reportable? A pituitary mass seen on imaging was "consistent with Microadenoma" on 11/15/2022. There was no histologic confirmation or treatment given.
Pituitary microadenoma is reportable. Assign 8272/0. "Micro" refers to size of the adenoma.
Per the SEER Program Coding and Staging Manual 2022, a reportable intracranial or CNS neoplasm identified only by diagnostic imaging is reportable, and "consistent with" is listed on the Ambiguous Terms to be used for Reportability list. As a result, this case is reportable.
Reportability--Bladder: Please explain the reportability of UroVysion for bladder cancer in the following circumstances.
1. Patient has positive UroVysion test and follow up biopsy is negative. Is this case reportable with a diagnosis date the date of the UroVysion?
2. Patient has positive UroVysion test and follow up biopsy is positive for cancer. Is the diagnosis date of the date of the positive UroVysion or the date of the positive biopsy? Thank you.
Do not report a case based on UroVysion test results alone. Report a case when there is positive histology, a physician statement of malignancy, and/or the patient was treated for cancer.
Surgery of Primary Site--Melanoma: If the surgical margins are greater than 1 cm for length and width but less than 1 cm for depth, do we code surgery in the 30-33 range?
Yes, assign a surgery code from the 30-33 range when any margin is less than 1 cm. Since tumor thickness is an important prognostic factor for cutaneous melanoma, the deep margin is of particular importance.
Refer to the Hematopoietic Database and Manual to determine the primary site.
Leukemias are coded to C421 [bone marrow]. The ONLY neoplasm that is coded to C420 [blood] is Waldenstrom's macroglobulinemia [9761/3].
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.
Date of Diagnosis--Sarcoma: Should the date of diagnosis be coded to the date of biopsy or the date of birth for an infant biopsied at 3 days of age and stated to have a diagnosis of congenital alveolar rhabdomyosarcoma, widely metastatic?
Code the date of the biopsy as the date of diagnosis. This is the date the cancer was first identified by a medical practitioner.
Note: SEER collects the Month and Year of diagnosis. The "day" of diagnosis is not collected by SEER.
First Course Treatment--Thyroid: Is hormone replacement following total thyroidectomy coded as first course treatment for all thyroid cases?
Code Hormone therapy as 01 [Hormone therapy administered as first course therapy] when thyroid replacement therapy is part of the first course of treatment for follicular or papillary thyroid cancer following thyroidectomy.
Thyroid hormone replacement therapy has a treatment effect on differentiated (follicular and papillary) carcinomas of the thyroid. This treatment effect is not seen for most medullary and undifferentiated thyroid cancers.
2018 EOD Primary Tumor/2018 EOD Mets--Lung: Is EOD Primary Tumor coded to 500 and EOD Mets 10 when there are bilateral lung nodules with nodules in same lobe as the primary tumor? How is EOD Primary Tumor coded when separate tumor nodes are in an ipsilateral lung but there is no documentation as to whether it is in the same or different ipsilateral lobe from the primary tumor?
Assign 999 to EOD Primary Tumor if this is the only information you have for your case.The mention of nodules does not automatically mean that you have separate tumor nodules. There are many reasons for the appearance of nodules in the lung, some of which are not due to cancer. Unless you have further information on whether the physician has determined that they are related to the lung cancer, then assume that they are not related.
Assign 00 to EOD Mets. Do not code EOD Mets to 10 since you cannot determine whether those nodules are based on the tumor or not.
If you are able to obtain more information, then you can update the EOD Primary Tumor and EOD Mets.
Regarding the second question, if separate tumor nodules are noted, you cannot assume that they are due to tumor. Further information, or clarification, is needed on whether the separate tumor nodules are related to the lung cancer. Without further information, code EOD Primary Tumor to 999.
Reportability/History (Pre-2007)/Behavior Code--Ovary: Should the matrix principal in Rule F be applied to code a 2002 right ovary case to 8462/3 [Papillary serous borderline ovarian tumor] when peritoneal washings reveal the same histology?
For tumors diagnosed prior to 2007:
Do not apply the matrix principle in this case. This ovarian tumor is not reportable (behavior /1 per ICD-O-3). The peritoneal washings reveal the same histology (/1), rather than malignant cells. Based on the information provided, there is no evidence to support changing the behavior code.
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.
Grade, Differentiation--All Sites: What code is used to represent this field when a pathology report describes a tumor as a low grade neoplasm consistent with a specific histologic type (e.g., Low grade neoplasm consistent with carcinoid)?
Code the Grade, Differentiation field to 2 [Low grade].