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Report Produced: 03/01/2026 03:34 AM

Report Question ID Question Discussion Answer Year
20031150 Histology (Pre-2007)--Breast: Should the histology "non-invasive papillary carcinoma" along with the comment "solid intraductal papillary proliferation includes cytologically atypical cells with scattered mitotic figures" be coded to 8503/2 [intraductal papillary carcinoma] or 8050/2 [papillary carcinoma in situ]?

For tumors diagnosed prior to 2007:

The best histology code for this breast case is 8503/2 [Noninfiltrating intraductal papillary carcinoma]. According to the WHO Classification of Tumors for Breast, Papillary carcinoma, non-invasive is a synonym for Intraductal papillary carcinoma. Further, code a more specific histologic type when found in the microscopic description, according to the SEER Program Code manual.

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.

 2003
20031017 Reason for No Surgery of Primary Site: Does code 2 [Contraindicated due to other conditions; autopsy only case] or code 1 [ Cancer-directed surgery not recommended] have priority when coding this field for extensive tumors not surgically treated because of existing comorbidities? See discussion.

Example:

Patient has Stage IVA carcinoma of the tongue. The physician states that patient is not felt to be a good surgical candidate secondary to multiple medical frailties. Patient is treated with beam radiation.

In this case, how do we code Reason for No Site Specific Surgery? Do we use code 2 because surgery was contraindicated due to co-existing medical conditions or do we use code 1 because the tumor is very extensive and surgery would probably not be done anyway?

SEER has not established a priority for assigning the Reason for No Surgery of Primary Site codes. Assign the code which best describes the reason surgery was not performed.

Example: Assign code 2, Contraindicated due to patient risk factors. According to the physician, this is the reason that surgery was not performed.

 2003
20031067 Primary Site/Histology (Pre-2007)/Sarcoma: How do you code these fields for a vulvar tumor diagnosed by FISH analysis as "extra-osseous Ewing sarcoma?" See Description. A literature search relates soft tissue malignancy described as "extra-osseous Ewing sarcoma/PNET." Neither are compatible with site.

For tumors diagnosed prior to 2007:

Code histology as 9260/3 [Ewing sarcoma]. ICD-O-3 does not have a code for extra-osseous Ewing sarcoma (EOE). Ignore the topography code listed in ICD-O and use the code for the primary site (vulva).

Site codes associated with morphology codes in the ICD-O are the most common sites and are not intended to limit coding only to those sites.

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.

 2003
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.

 2003
20031202 Surgery of Primary Site--Head & Neck: How is this field coded for a surgery titled "Parotidectomy with facial nerve dissection"? See Description. If the operative report is not titled "total parotidectomy," can we assume that less than total parotidectomy was done? Can we assume that "facial nerve dissection" and "facial nerve monitoring" are other ways of stating "facial nerve spared"?

Use the best information available to determine whether or not all of the parotid has been removed. It is important to read the entire operative report and review the content of the pathology report. The Op report will usually include wording about how much was removed, and this can be confirmed by the path report. Do not make assumptions about the extent of the surgery based solely on the title used on the operative report.

For cases diagnosed 1998-2003: Code 30 [less than total parotidectomy] can be used when the parotid is not totally removed, but the exact type of partial parotidectomy cannot be determined. "Facial nerve monitoring" and "Facial nerve dissection" are synonymous with "facial nerve sparing."

 2003
20031106

Reportability--Appendix: Is an appendiceal carcinoid with one periappendiceal lymph node positive for metastatic carcinoid tumor reportable to SEER? See Discussion.

The patient had an appendectomy followed by a hemicolectomy. No residual carcinoid tumor was identified but there was one lymph node positive for metastatic carcinoid tumor.

Yes, this carcinoid is reportable to SEER. This carcinoid is malignant by virture of the lymph node metastasis. Code the behavior as /3.

2003
20031050 Radiation Sequence with Surgery: How is this field coded when radiation was recommended but it is unknown whether radiation was ever given? Assign code 0 [No radiation and/or cancer-directed surgery]. Code Radiation Sequence with Surgery as 0 when radiation is coded 8. 2003
20031060

Histology--Hematopoietic, NOS: Because histology 9895/3 [Acute myeloid leukemia with multilineage dysplasia] was recognized as a distinct entity by WHO with too few cases of the subtypes [with or without prior MDS] to warrant separate histology codes for each, should the wording for the non-bold definitions in ICD-O-3 be changed to the following in both the alpha and numeric sections? See Description.

AML with multilineage dysplasia and prior MDS

AML with multilineage dysplasia and without prior MDS

How do we code histology for the following case of AML?

Patient was admitted for profound anemia and thrombocytopenia with

no immediate explanation. Path final diagnosis on bone marrow biopsy: acute myelogenous leukemia (AML). Per micro description: findings are

characteristic of AML that appears to be arising within the context of a myelodysplastic syndrome. The discharge diagnosis (2 days after bone marrow biopsy) read: myelodysplastic syndrome with profound anemia and

thrombocytopenia.

Do we code the histology per the final path diagnosis (code 9861/3)?

Using the current version of ICD-O-3, we could arrive at a histology code of 9895/3 based on the micro findings of AML with prior myelodysplastic syndrome. However, per the above-mentioned SEER e-mail, we would not because there was no mention of multilineage dysplasia.

For cases diagnosed prior to 1/1/2010:To assign code 9895, it is important that the diagnosis includes "multilineage dysplasia." Use code 9895 when the diagnosis is with or without prior (not concurrent) myelodysplastic syndrome AND multilineage dysplasia. Acute myeloid leukemia without prior myelodysplastic syndrome and without multilineage dysplasia is coded 9861 [Acute myeloid leukemia, NOS].

Although the wording of 9895 cannot be changed, coders can make a note that the synonyms are intended to include:

-Acute myeloid leukemia WITH multilineage dysplasia with prior myelodysplastic syndrome

and

-Acute myeloid leukemia WITH multilineage dysplasia without prior myelodysplastic syndrome.

The histology code for the case example is 9861/3 [Acute myeloid leukemia, NOS].

For cases diagnosed 2010 forward, 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.

 2003
20031128 Histology (Pre-2007): What code is used to represent the histology "PD infiltrating duct ca with focal sarcomatoid pleomorphic features?"

For tumors diagnosed prior to 2007:

Code histology as 8500/33 [Infiltrating duct carcinoma, poorly differentiated]. "Features" is a term from the list indicating a majority of the tumor, however; in this case "features" is modified by "focal" which does not indicate a majority of the tumor.

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.

 2003
20031151 EOD-Size of Primary Tumor: Can size be coded from a needle bx that removes all of the invasive tumor and just leaves a "focus of in situ"? See Description. For example: needle bx diagnosis is "tiny focus of tissue highly suspicious for tubular ca." The lumpectomy path states "single focus of low grade DCIS, no residual ductal ca." Can size be coded 001? Code tumor size to 001 [Microscopic focus or foci only] for the invasive component. Code the tumor size 990 for cases diagnosed in 2004 and forward. Disregard the microscopic tumor found at further resection. 2003