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Endocrine mucin-producing sweat gland carcinoma (EMPSCG) is a rare type of low-grade sweat gland carcinoma. Some journal articles indicate that most patients with EMPSCG have coexisting mucinous carcinomas, suggesting that EMPSCG is a precursor to invasive mucinous carcinoma of the skin. Sweat gland carcinoma has its own histology code per the ICD-O-3 (8400/3); should an endocrine mucin-producing sweat gland carcinoma also be coded as 8400/3? If so, would the correct histology for the skin case above be mucinous carcinoma (8480/3) per Rule H17? Conversely, if the terms "mucin-producing" are referring to mucin-producing carcinoma, and not referring to the sweat gland carcinoma, would the histology be coded 8481/3 (mucin-producing carcinoma)?

There is a 1988 case that hit the SEER edits for other reasons but not because of that site/histo combination (C000 and 8090/3); however, there is no text.

Per a Dataminer query, there are 42 cases in the state database with C000-C009 and 8090.  On review, a few did have a mention of the word "upper lip/mucosa" in the PE text or OP findings (not path because a lot of these are removed in the MD office and we don't see the path report). Other times, there is no mention but the abstractor used the C00 codes instead of C44 so the cases get through.

SINQ #20031110 addresses this in relation to C000, Lip, NOS but we want to know if this answer meant you would never report a basal carcinoma lip case period (even if there is a mention of mucosa or any mention of mucosa in the path report). Are there any exceptions?

It seems if you would never report a basal lip carcinoma, then SEER would block those cases from being reported/submitted and the wording would be stronger in the SEER manual.

Right now the reportability only addresses if someone codes C44 but if someone decides to use C00 codes then it is allowed. Under Primary Site, there is even a listing under 12 for "absence of any additional information" and lists "Colored / lipstick portion of upper lip" as code C000.

The diagnosis date is 2/24/14.  The pathology report of the pancreas shows: Well-differentiated neuroendocrine tumor (NET), low grade (WHO G1 of 3). Addendum: Ki-67 confirms low grade of pancreatic endocrine tumor (less than 2% Ki-67/MIB-1 index). Chromogranin confirms the endocrine nature of the tumor. The Pre and Post Op Diagnosis is pancreatic neuroendocrine tumor consistent with insulinoma. AJCC Stage as noted on path report: pT1, pNX, pM.

The physician states: The patient has a well-documented insulinoma. Biochemistries confirmed the disease and it is localized in the tail of the pancreas.

The issue with NETs is that pathology report reflects what is seen or what is quantified under the microscope; often, there is a specimen without the accompanying medical history and clinical signs. Many of these NETs are specified on the basis of the hormone, as usually measured in the blood, that is overproduced, something not seen microscopically. All of the islet cell tumors are NETs. The insulinoma in the example above is a well-differentiated NET that is causing insulin to be over-produced. Thus, the diagnoses are not discordant; insulinoma is a more specific NET.

Is the instruction under #4.b. on page 114 of the 2014 SEER Program Coding and Staging Manual incorrect? It says to code Rituxan as chemotherapy.  

Should it be coded to where the testis was physically at the time of diagnosis (C621), or should it be coded to C620 to reflect the increased risk for developing malignancy in an undescended testis?

The MRI states "Lhermitte-Duclos disease" but does not include "dysplastic gangliocytoma of cerebellum"; is this the same as "Lhermitte-Duclos dysplastic gangliocytoma of cerebellum (C716)"?

Examples

8/xx/13 TURBT with path specimen (27): Papillary Urothelial Carcinoma, HG    9/xx/13 Bladder fulgeration w/o path specimen (12)

5/xx/14 Segmental Mastectomy(24): Ductal carcinoma with <1mm marg    6/xx/14 Breast Re-excision (23): Residual ductal carcinoma 1.5mm, marg neg

There are multiple SEER Notes in the Breast Surgery Codes of Appendix C instructing us to code tissue expanders as reconstruction but none address the type of reconstruction to be coded.

1. Is a tissue expander always equivalent to Implant reconstruction?

2. Is AlloDerm always equivalent to Tissue reconstruction?

3. Is the combination of AlloDerm and tissue expander always equivalent to Combined (tissue and implant) reconstruction?