CS Lymph Nodes/CS Mets at DX--Ovary: How are the following lymph node regions/chains coded in the Collaborative Stage schema for ovary?
1. pericolonic
2. pelvic, NOS
3. mesenteric, NOS
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.Revised 7-17-09
Assign CS Lymph Nodes code 10 for involvement of pelvic lymph nodes, NOS.
Code involvement of pericolonic nodes or mesenteric nodes, NOS in CS lymph nodes.
CS Extension--Corpus uteri: Can a suspicious cytology be used to code extension? See Discussion.
Endometrial primary confirmed by biopsy on 10/26/06. Pelvic washing on 11/14/06 was 'suspicious for malignancy.' Resection path the same day stated the primary tumor invades the inner 1/3 of the myometrium.
Can we use the pelvic washing cytology & code CS extension 61 or should CS extension be coded 12?
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.Assign extension code 61 [cancer cells in peritoneal washings] for the case described above.
"Suspicious" is listed as a term indicating involvement. There is no exception noted for cytology reports. See page 122 of the 2007 SEER manual.
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.
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.
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.
Laterality--Brain and CNS: When a meningioma extends to both right and left sides, is laterality coded 4 for bilateral or 9 for midline? See Discussion.
Operative Findings: Bilateral frontal craniotomies for excision of giant meningioma which extended onto optic chiasm.
Path: Bifrontal tumor, 6.5 cm meningotheliomatous meningioma.
If it is not possible to determine whether the meningioma originated on the left or the right, assign code 4 [Bilateral involvement, lateral origin unknown; stated to be single primary].
First course treatment: Is subsequent treatment with R-ICE first course or second course therapy if the patient underwent ABVD x2 cycles and subsequent imaging showed no response to treatment and evidence of progression [new adenopathy] for a lymphoma case? See Discussion.
Patient was initially diagnosed with Hodgkin Lymphoma, Nodular Sclerosing on 3/3/06.
Patient received ABVD x 2 cycles. Had disease reassessed in May, 2006, no response to treatment, showed evidence of progression (new adenopathy). Patient's pathology from 3/06 was sent for consult: Diagnosis was Hodgkin with some overlapping features of B-cell Non Hodgkin Lymphoma. Treated 5/18/06 with R-ICE FOR NHL.
The R-ICE treatment in this case is not part of the first course. Documentation of treatment failure and/or disease progression signifies the end of the first course of treatment.
MP/H Rules--Melanoma: How many primaries are represented if subsequent to a diagnosis of malignant melanoma of skin of left thorax in April 2006, a metastatic melanoma is discovered in the soft tissue of the abdomen and in the skin and subcutaneous tissue of the groin in late 2007? See Discussion.
4/20/06: skin left lateral thorax, excision: Pedunculated malignant melanoma, 0.5 CM in height, Clark's level 3, Breslow depth 0.5 CM, superficial ulceration noted. No host response. Margins clear.
6/19/06: Four sentinel LNs negative. Interferon therapy.
10/30/07: FNA of soft tissue, left lower abdomen: consistent with metastatic melanoma.
12/20/07 A) sentinel lymph node, left groin, biopsy: No morphologic or immunophenotypic findings support for metastatic melanoma (see comment). B) skin and subcutaneous tissue, left groin, excisional biopsy: Metastatic malignant melanoma (see comment). Lymphovascular invasion identified. Margins free of melanoma. Melanoma 1.5 MM from the closest designated deep margin and 5 MM from the designated 6:00 margin. C) skin, left groin/additional inferior margin, excisional biopsy: No significant histopathologic abnormality. No evidence of villus or melanoma or malignancy. Comment: A 0.8 cm metastatic nodular melanoma is present in the adipose tissue. The underlying skin is unremarkable. There is no evidence of ulceration, melanocytic lesion, melanoma in situ, or regression of melanoma. Block A1 is sent for immunohistochemical studies. The immunophenotypic findings provide no support for metastatic melanoma in lymph node. Please see the immunohistochemical study. The primary MD states "Recurrent intransit mets, left groin."
For cases diagnosed 2007 or later, this is a single primary, melanoma of the thorax 4/20/06. The subsequent reports mention metastases, but do not document another primary. Do not count metastatic lesions as new primaries.
Multiplicity Counter: Should this field be coded to 99 for cases of familial adenomatous polyposis (FAP)? See Discussion.
The MP/H rules state to abstract these cases as a single primary. The Type of Multiple Tumors Reported as One Primary field is coded as a single primary with a value of 32 (FAP with carcinoma), but the Multiplicity Counter seems to be unknown.
Assign code 99 [Multiple tumors present, unknown how many] for cases of FAP when the number of tumors is not stated.
CS Extension/CS Mets at Dx--Wilm's Tumor: Is the fact that a Wilm's tumor case is bilateral captured in the CS Extension field or is the CS Mets at Dx field coded to 40?
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.Code laterality as bilateral, code the greatest extension from either side in CS extension.
Code CS Mets at diagnosis 00 [None] UNLESS true distant metastases were identified.
An official website of the United States government
Home