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Report Produced: 09/14/2025 13:58 PM

Report Question ID Question Discussion Answer Year
20081107 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. 2008
20081001

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.

Answer from:

  • I & R System

  • American College of Surgeons

    		•  2008
    		20081126

    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.

    1. 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.

    		 2008
    		20081122 MP/H Rules/Histology--Breast: Patient has single invasive left breast tumor diagnosed in 2008. Final pathology diagnosis is "Invasive solid papillary carcinoma". No mention of ductal in report. What is histology?

    For cases diagnosed 2007 or later:

    As of July 2010:

    Code the histology 8503 [Infiltrating papillary adenocarcinoma].

    This is solid papillary, not solid AND papillary carcinoma. Solid is an adjective modifying papillary, in other words, a subtype of papillary. We do not have a code for solid papillary, so we code to the NOS, papillary using rule H14.

    		 2008
    		20081034 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. 2008
    		20081113

    Reportability--Brain and CNS: Is a cavernoma reportable as a benign brain tumor? See Discussion.

    Cavernous hemangiomas are typically described as vascular malformations in the brain. Per a search of the literature, cavernoma, cavernous hemangioma and cavernous malformation are all synonymous. There is some controversy as to whether cavernomas are vascular malformations or tumors. Cavernous hemangioma (9121/0) has been assigned a code in the ICD-O-3. The other terms are not even listed. Benign brain guidelines indicate that named tumors that have been assigned an ICD-O-3 code are reportable. Would we report a lesion that is labeled cavernous hemangioma but not one that is labeled carvernoma? Are cavernous malformations of the brain to be reported as benign brain tumors? The MP/H guidelines for benign brain tumors do not include blood vessel tumors in chart 1.

    Are the following tumors reportable? If so, what is the primary site?

    Example 1: Patient admitted for resection. Clinical diagnosis is left temporal cavernous hemangioma. Path diagnosis is cerebral cortex and white matter showing cavernoma.

    Example 2: Patient admitted for resection with clinical diagnosis of parietal cavernous hemangioma. Path shows A-V malformation.

    Example 3: Patient had T4 spinal tumor removed. Path showed cavernous angioma.

    Reference: I&R 18109 and 23460

    Cavernoma is a reportable benign brain tumor. According to our pathologist consultant, cavernoma is synonymous with cavernous hemangioma.

    Examples

    1. Reportable. Primary site - C710 [cerebrum]

    2. Not reportable. Path dx disproves clinical diagnosis.

    3. Not reportable. Not a brain tumor.

    		 2008
    		20081066 Multiplicity Counter/Type of Multiple Tumors--Breast: How should these fields be coded when path shows a 1.2 cm infiltrating carcinoma with lobular features and several foci of infiltrating lobular carcinoma [7 foci described as multifocal], 1 large focus, and numerous foci of LCIS and CIS with lobular and ductal features? Should we count the foci or separate tumor nodules, ignore them, or code unknown values for these fields? See Discussion.

    Scenario: 10/17/07: Right axilla soft tissue bx - infiltrating mammary ca with lobular features arising within apparent breast tissue present within axilla. Tumor size 1.2 cm. 11/3/07: Right breast, reexcision lumpectomy - Several foci of infiltrating lobular CA. (2) foci & (5) foci within specimen (multifocal). (1) large focus also present. No lymphovascular invasion identified. Numerous foci LCIS. Pleomorphic LCIS & CIS with lobular and ductal features. Margins free of invasion however margins diffusely involved with LCIS.

    When do you count foci or separate tumor nodules, when do you ignore them, and when do you code unknown values for these fields? Coding instruction 3b states, "When the tumor is multifocal or multicentric and the foci of tumor are not measured, code as 99." Instruction 4b states, "Use code 01 when there is a single tumor with separate foci of tumor." Finally, instruction 6b states, "Use code 99 when the tumor is described as multifocal or multicentric and the number of tumors is not given," which seems to imply that if we know the number of tumors, we would code that number.

    Multiplicity Counter: Use instruction 4b. Since there is one measured tumor and the foci were not measured, code the multiplicity counter 01 [One tumor only].

    Type of Multiple Tumors: Code Type of multiple tumors 00 [Single tumor].

    		 2008
    		20081131 MP/H Rules--Colon: What histology would you assign to a single tumor with the histology 'well differentiated mucinous cystadenocarcinoma in a villous adenoma confined to the appendix'? Does rule H4 apply to this diagnosis or should we continue on in the rules to H14 and code the higher histology?

    For cases diagnosed 2007 or later, use rule H4.

    Stop at the first rule that applies to the case. Rule H4 is the first rule that applies.

    The polyp rule, H4, comes before many of the other colon rules because it is important to know that the malignancy originated in a polyp.

    		 2008
    		20081135

    MP/H Rules--Lung: Per rule M8, tumors of the same site (left lung), same histology (NSCC), greater than 3 yrs apart are separate primaries.

    However, there was a recurrence to mediastinal LNs after 2 years. Would that make a difference as to whether the 2008 left lung carcinoma is reportable as a new primary or not? See Discussion.

    		 Scenario: NSCC 2004 LLL with positive hilar/mediastinal LNs treated with LLL lobectomy, chemo and rad. 2006 per CT/PET recurrence in mediastinal LNs treated with chemoradiation. 2008 left lung nodule positive for NSCC stated by MD to be recurrence from 2004 (2008 path not compared to 2004 path).

    For cases diagnosed 2007 or later:

    The 2008 lung carcinoma is a separate primary according to rule M8. The 2006 diagnosis is metastases to the lymph nodes. Do not apply the MP/H rules to metastases.

    		 2008
    		20081085 MP/H Rules/Histology--Colon: Per MP/H rule H3 for colon, code 8144/3 [Adenocarcinoma, intestinal type] should not be used with C180-C189 [colon]. However, page 58 of the ICD-O-3 SEER Site/Histology Validation list of February 9, 2001 lists code 8144/3 as a valid histology for large intestine. See Discussion. None of the errata have this site/histo combination. It is causing problems with researchers because pathologists still use the term: Adenocarcinoma, intestinal type for tumors of the large bowel. Please clarify or print errata.

    For cases diagnosed 2007 or later:

    This issue has been presented to the Edits work group. The preliminary response is that 8144/3 will be removed from the valid site/histology list for large intestine, small intestine, and rectum.

    The edits based on the site/type list are used by many organizations. Any change to the site/type list is taken to the Edits work group.

    		 2008