Reportability--Lung: Is carcinoid tumorlet of the lung a reportable disease? See Discussion.
The literature on this is rather ambiguous as to whether these tumorlets (defined as <0.5 cm) are benign, such as atypical hyperplasia, or actual carcinoid tumors.
Carcinoid tumorlets are not reportable. The histology can be similar to typical carcinoids; however, they are <5 mm in diameter and are benign/nonreportable.
Multiplicity Counter/Ambiguous terminology: How should these fields be coded for cases with an unknown date of diagnosis?
If the date of diagnosis is unknown, it is likely that you have little information for this case. Both multiplicity counter and ambiguous terminology fields would probably be coded as unknown. However, if information on the number of tumors and the diagnostic confirmation are available, code these fields as specified in the manual.
MP/H Rules/Histology--Breast: What is the histology code for the following?
4/21/03 Left breast: infiltrating ductal carcinoma, grade 3 micropapillary type. Tumor size: 3.5 cms; deep margin negative. Skin, nipple & areola positive for invasive ductal carcinoma. Dermal lymphatic invasion by carcinoma breast. Extensive intraductal component absent. 6+/6. See Discussion.
How should histology be coded for a 2003 diagnosis and also for the same diagnosis in 2007 or later?
For a case diagnosed in 2003, code 8507/3 [Duct micropapillary carcinoma]. See Coding Complex Morphologic Diagnoses, revised August 2002, 3rd example on page 5 and page 3, #4.
For cases diagnosed 2007 or later, code 8507/3 [Duct micropapillary carcinoma]. Use rule H12.
MP/H Rules--Breast: Is inflammatory breast cancer always one primary per lifetime? Or is a subsequent inflammatory breast cancer a second primary if diagnosed more than five years later?
For cases diagnosed 2007 or later, a diagnosis of inflammatory breast cancer more than five years after a previous diagnosis of inflammatory breast cancer is a separate (new) primary. See rule M5 in the Breast Multiple Primary Rules.
Histology/Behavior--Brain and CNS: How are these fields coded for an "anaplastic glioneuronal neoplasm with spongioblastic architecture"? See Discussion.
Scenario: Addendum from Mayo Clinic review, IHC and consultation made dx of "anaplastic glioneuronal neoplasm with spongioblastic architecture". The original micro states 'high grade glial neoplasm w/o characteristic features of glioblastoma multiforme in that it lacks areas of significant necrosis, no nuclear palisading nor endothelial vascular proliferation...."
The best code available according to our pathologist consultant is 9505/3 [Ganglioglioma, anaplastic]. According to our consultant, while ganglioglioma is traditionally a benign tumor, anaplastic ganglioglioma is classified as malignant by WHO (page 103), and comes as close to fitting the description of this tumor as any other term.
MP/H Rules--Brain and CNS: Are stigmata of neurofibromatosis in the brain reportable neurofibromatosis lesions? See Discussion.
Reference: SINQ 20051108; SINQ 20061018 Three year old patient with history of neurofibromatosis 1. 3/05 MRI of the brain showed right optic nerve glioma. It also showed heterogeneous high t2 signal in the middle cerebellar peduncles and near the genu of the internal capsules bilaterally are stigmata of neurofibromatosis type I. 3/08 MRI showed new mass suspicious for glioma in the hypothalamus. Clinical diagnosis is benign glioma secondary to diagnosis of neurofibromatosis. How many primaries are to be accessioned for this patient? Should the matrix principle be invoked for the second glioma? Should the behavior code for the glioma be 0?
For cases diagnosed 2007 through 2017
Accession NF (9540/1) when there is CNS tumor -- a glioma or some other intracranial/intraspinal tumor. Stigmata of NF are reportable when the stigmata themselves are reportable tumors. For example, glioma, or another intracranial/intraspinal tumor. Do not report sitgmata that are only termed "stigmata seen on MRI," for example, without other reportable terminology.
Do NOT accession NF (9540/1) when there is only peripheral nerve/nervous system involvement.
Accession the neurofibromatosis itself only once per patient. Accession any initial neoplasm in the CNS separately. Abstract and code any subsequent CNS neoplasms according to the multiple primary brain rules.
Accession three primaries for the case described above.
Neurofibromatosis (C729 9540/1)
Optic nerve glioma (C723 9421/3)--> see below.
Hypothalamus glioma (C710 9380/0)
--> Optic nerve gliomas associated with NF are pilocytic astrocytomas. Code pilocytic astrocytoma as 9421/3 in North America.
For cases diagnosed 2018 or later
See the 2018 Solid Tumor Rules for Non-Malignant CNS tumors.
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.
Histology--Breast: What is the histology code for a 2007 diagnosis of basal-type breast carcinoma?
Code basal-type breast carcinoma to 8500/3 [Infiltrating duct carcinoma, NOS].
Basal-type breast carcinoma is a subtype of infiltrating duct carcinoma thought to have a poorer prognosis. There is no specific ICD-O-3 code for basal-type breast carcinoma.
CS Tumor Size: Can an 'ulcerated mass' be used to code CS tumor size? See Discussion.
The CS Manual (p. 26, 4.a.) states do not code the size of the polyp, ulcer or cyst. However it states that a 'cystic mass' can be used to code TS if it is the only size given. Scopes Text: 'ulcerated' mass based at anal verge & ext 3-4 cm up into rectum.
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.Do not code CS Tumor size using the size of an ulcerated mass.