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Report Produced: 03/03/2026 23:32 PM

Report Question ID Question Discussion Answer Year
20091072 Histology--Brain and CNS: How is histology coded for a "rosette-forming glioneuronal tumor" of the fourth ventricle?

Assign histology code 9505/1 [Ganglioglioma, NOS].

Rosette-forming glioneuronal tumor of the 4th ventricle is a new WHO entity. There is no current ICD-O-3 code for this. The best code available at this time is 9505/1.

 2009
20091001 CS Lymph Nodes/CS Mets at DX--Ovary: Are lymph nodes in the pericolic mesentery of the sigmoid that are removed during ovarian cancer debulking surgery, coded as regional or distant? See Discussion. Debulking surgery found tumor in both ovaries and in lymph nodes of pericolic mesentery, which was removed en bloc with a segment of sigmoid colon (colon had tumor implants involving serosa). Pericolic nodes are not listed as regional for ovary. However Note 2 in the CS manual for Extension states "sigmoid mesentery" is a regional pelvic organ, and that metastatic deposits here should be coded in the extension field, not as distant mets. Should lymph nodes from this same area be coded as regional or distant?

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.

Lymph nodes in the mesentery of the sigmoid colon are regional for an ovarian primary. Code involved sigmoid mesenteric nodes under CS Lymph Nodes.

 2009
20091114 MP/H Rules/Multiple primaries--Breast: Would a left chest wall mass excision stated to be ductal carcinoma consistent with a breast primary and, "compatible with either local recurrence or potentially a metastasis" be a new primary per the MP/H rules? See Discussion. Patient underwent mastectomy in 1986 for infiltrating ductal carcinoma of left breast. Excision of left chest wall mass in March 2009 showed ductal carcinoma consistent with breast primary. The pathology report COMMENT stated it would be compatible with either local recurrence or a metastasis. The patient's primary breast carcinoma material is not available for direct comparison and the MP/H rules instruct us to ignore metastasis. For cases diagnosed 2007 or later, the MP/H rules do not apply to metastasis. If there is no further information available for this case, the MP/H rules do not apply to the 2009 diagnosis. 2009
20091113 MP/H Rules/Histology--Breast: How is histology coded when a nipple biopsy shows Paget disease but the mastectomy specimen shows only infiltrating ductal carcinoma in the breast tissue and the nipple is negative for Paget disease? See Discussion. Biopsy of nipple showed Paget disease. Subsequent mastectomy showed two tumors proven to be infiltrating ductal carcinoma. Nipple is negative. Per MP/H rule M9, this is all counted as a single primary. Do we code histology from the most representative specimen and lose the information about the Paget disease? For cases diagnosed 2007 or later, code the histology 8541/3 [Paget disease and infiltrating duct carcinoma]. Paget disease of the nipple and infiltrating duct are separate tumors. For each tumor, take the histology from the most representative specimen. The biopsy is the most representative specimen for the Paget disease. The mastectomy is the most representative specimen for the infiltrating duct. According to the multiple primary rules, tumors that are Paget disease and duct are a single primary (M9). According to the histology rules, assign code 8541/3 (H26). 2009
20091125

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. 2009
20091096 MP/H Rules/Multiple primaries--Breast: How many primaries should be reported when an in situ diagnosis is followed by an invasive diagnosis in the same breast 1.5 years later? See Discussion. Patient had a core biopsy 1/07 that showed DCIS and PE showed no adenopathy. Patient refused resection, and adjuvant treatment. In 6/08, the pt returned for a modified radical mastectomy which showed infiltrating duct carcinoma and positive lymph nodes. A comment in the Correction Record stated "Per MD, patient did not see any urgency and delayed surgery 1.5 years after diagnosis." The patient did not have any treatment in that time period and there is no statement that there was progression. For cases diagnosed 2007 or later, abstract the 6/08 invasive diagnosis as a separate primary according to rule M8. Rule M8 applies whether or not the later diagnosis in this case is progression of disease. 2009
20091095 CS Site Specific Factor--Prostate: Please clarify how SEER registries should use code 040 for Site-Specific Factor 3 on prostate cases. See Discussion. The 6/11/09 NAACCR Webinar on prostate cancer pointed out that SSF 3 code 040 refers the registrar to Note 4, which states "when the apical, distal urethral, bladder base, or bladder neck margins are involved and there is no extracapsular extension, use code 040." The webinar went on to say that code 040 ONLY applies to these specific margins, and that if other margins are involved (for example, the 'right lateral margin'), we should not use code 040. Is this consistent with SEER's interpretation of Note 4? Are we to ignore involvement of margins other than those specified in Note 4, and consequently code SSF 3 within the 000-032 range? Would this also apply to code 048 (extracapsular extension and margins involved)?

Yes, SEER agrees. Code SSF3, code 040 per page C-740 of 2007 SEER manual exactly as stated in Note 4. According to the Inquiry and Response System of the CoC, Note 4 lists specific margins that were once thought to have a prognostic impact. Code 040 in SSF3 should be used only when those margins are involved.

Note 4 pertains to code 040, not to code 048.

2009
20091054

First course treatment--Liver: Is planned therapy second course therapy if it is administered after documented progression of disease? See Discussion.

A patient with hepatocellular carcinoma of the liver is waiting for a planned liver transplant. During the waiting period, a CT showed an increase in the liver nodule. The physician performed a bridging chemoembolization. Later on, the patient received a liver transplant. Is the liver transplant still first course treatment? Is the chemoembolization part of first course therapy? Per the SEER manual, first course therapy ends when the treatment plan is completed.

In this case, neither the chemoembolization nor the liver transplant is part of the first course of therapy. The documented treatment plan was changed after disease progression. Chemoembolization was not part of the original treatment plan. First course therapy ends at this point.

 2009
20091029 MP/H Rules/Histology--Melanoma: How should histology be coded for a melanoma arising in a compound nevus, NOS or a nevus, NOS?

For cases diagnosed 2007 or later, assign code 8720 [Melanoma, NOS] to melanoma arising in a nevus that does not have a specific code or to melanoma arising in a nevus, NOS.

Currently, ICD-O-3 does not have a specific classification for a melanoma arising in a compound nevus.

 2009
20091052 Multiple Primaries--Lymphoma: How many primaries should be reported when a left tonsil biopsy is diagnosed with marginal zone lymphoma (9699) and a cervical lymph node biopsy is diagnosed with marginal zone lymphoma and grade 3 follicular lymphoma (9699 and 9698)?

For cases diagnosed prior to 1/1/2010:

Abstract two primaries: The first is a marginal zone lymphoma of tonsil and the second is a follicular lymphoma of cervical lymph node. According to the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases (the tri-fold chart), marginal zone lymphoma (9699) and follicular lymphoma (9698) are different primaries.

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.

 2009