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20061017 | CS Eval--Prostate: How is CS Ts/Ext Eval to be coded for a clinically inapparent prostate cancer that is treated with Lupron and a subsequent prostatectomy? See Discussion. | Patient diagnosed with prostate cancer on biopsy for elevated PSA, CS extension code 15. Patient then receives 4 courses of Lupron. Subsequent radical prostatectomy shows bilateral lobe involvement with capsule invasion, SSF 3 pathologic extension code 032. | 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 CS TS/Ext Eval 6 [surgical resection performed with pre-surgical systemic treatment, tumor size/ext based on path evidence]. For prostate, CS TS/Ext eval must reflect coding of CS extension and SSF 3. In this case, SSF 3 code 032 is based on the prostatectomy information which occurred after systemic treatment. |
2006 |
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20061057 | CS Extension--Lung: Can extension be coded to 10 (Tumor confined to one lung) when either an autopsy or a CT scan describes the tumor as a mass of a specified size located in one lobe of the lung without any description of extension and no available TNM provided? See Discussion. | Example 1: Lung primary within the right lower lobe described clinically as greater than 3 cm on scan but was found to be 3 cm at autopsy. Example 2: CT scan February shows 2 cm mass in RUL. In both cases, the only tumor description was the size of tumor without any information regarding extension. |
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. Yes, assign code 10 [Tumor confined to one lung] for a mass in one lobe when none of the descriptions in codes 11 to 80 are documented. |
2006 |
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20061061 | CS Lymph Nodes--Breast: Clarify the use of code 25 [Movable axillary lymph node(s), ipsilateral, positive with more than micrometastasis (i.e., at least one metastasis greater than 2 mm)] vs code 60 [Axillary/regional lymph node(s), NOS; Lymph nodes NOS] when surgically removed lymph nodes are positive but the size of the metastasis is not stated. See Discussion. | Note 2 in CS manual states: "If the pathology report indicates that nodes are positive but size of the metastases is not stated, assume the metastases are greater than 0.2mm and code LNs as positive in this field. Use code 60 in the absence of other information about regional nodes." 1. If the LNs are known to be axillary LNs, note 2 seems to imply the size can be assumed to be greater than 0.2mm. Would you code 25 or 60? 2. Both codes 25 and 60 map to N1, node involvement. Do they each mean something else in the evaluation process? 3. What would constitute "absence of other information"? 4. Is the use of 60 over 25 specific to SEER registries or all users? 5. Abstractors are trained to assume LNs are mobile if there is no contrary information. Is this appropriate? |
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 CS Lymph Nodes code 25 for breast when there are positive axillary nodes without internal mammary nodes. Code 25 is used in a couple of situations: a. when you know the lymph nodes are clinically movable and only the axillary nodes are involved; b. when you know the size of the metastasis in an axillary lymph node is more than a micrometastasis (i.e., > 2 mm). Code 60 can be used for any regional lymph node (internal mammary, infra- or supraclavicular, as well as axillary. So you can code to 25 if you have "regular" metastases in axillary lymph nodes only. If you don't know whether the mets are micro or regular, use code 60. Assign code 60 when there are positive regional nodes not further described. 1. Assign code 25 for positive axillary lymph nodes. 2. Codes 25 and 60 may map to N1, N1a, N2a or N3a depending on the coding of SSF3. 3. Assign code 60 when there is not enough information to assign a code from 13 to 50. 4. CS instructions are the same for all users. There are no CS instructions specific to SEER registries. 5. Yes, assume lymph nodes are moveable (not matted, not fixed) when there is no information to the contrary. |
2006 |
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20061106 | Reportability--Hematopoietic, NOS: Is a "Myelodysplasia, refractory macrocytic anemia with multilineage dysplasia" reportable? | For cases diagnosed prior to 1/1/2010:Yes, myelodysplasia, refractory macrocytic anemia with multilineage dysplasia is reportable. This is a type of refractory anemia. Refractory anemia is reportable. 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. |
2006 | |
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20061127 | CS Lymph Nodes--Esophagus: Is a resected positive "periesophageal nodule" coded as an involved lymph node for an esophagus primary? See Discussion. | Per SINQ 20000846: Each gross nodule of metastatic carcinoma in the fat surrounding an organ is counted as one positive regional lymph node. SINQ 2000846 applied to EOD. Can this concept be used for Collaborative Stage? | 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. For cases diagnosed on or after January 1, 2004: Search for additional information on the "nodule." Review the gross and microscopic descriptions to determine whether or not the nodule is a lymph node. If it is not possible to obtain further information, apply the downstaging rule and select the Extension or LN code that results in the lower category. |
2006 |
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20061092 | CS Tumor Size--Breast: Should this field be coded to 999 [Unknown] or 008 [0.8 cm tumor] when the tumor size is not provided on a stereomammotomy biopsy for an in situ malignancy and a subsequent excision demonstrates 0.8 cm tumor of residual in situ disease? | 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 CS tumor size 008 [0.8cm]. A mammotomy specimen is very small, so for this case, the residual tumor size is quite accurate. Size is not a critical data element for in situ breast cancer. |
2006 | |
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20061062 | Reportability: Is a "pleomorphic hyalinizing angiectatic tumor of soft parts (PHAT)" reportable if the case has a TNM stage assigned and is stated by the pathologist to be a rare intermediate grade sarcoma? | Pleomorphic hyalinizing angiectatic tumors of the soft parts are not reportable. According to our pathologist consultant, PHAT is a borderline malignancy (/1). While the true nature of these tumors is under debate (reactive vs. neoplastic), so far none have metastasized. |
2006 | |
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20061138 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How many primaries are to be abstracted and how is the histology field(s) coded when a nipple biopsy demonstrates Paget disease and a separate biopsy in the same breast demonstrates inflammatory breast carcinoma? See Discussion. | Should Paget disease be coded as the histology because it has a higher histology code than inflammatory carcinoma? | For tumors diagnosed prior to 2007:
Abstract the inflammatory carcinoma as one primary and the Paget disease as a separate primary. The first three digits of the histology codes for these histologies are different (8530 and 8540). Therefore, these are separate primaries.
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. |
2006 |
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20061072 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Brain and CNS: How many primaries should be abstracted and should the histology field(s) be coded to 9530/1 [Meningiomatosis, NOS] or 9530/0 [Meningioma, NOS] to represent a case that presents with MRI confirmed multiple meningiomas (e.g., left dura, right parasagittal region, and left frontal lobe)? | For tumors diagnosed prior to 2007:
Abstract this case as two primaries, right and left cerebral meninges. Code the histology for both primaries to 9530/0 [Meningioma, NOS]. Use code 9530/1 [Meningiomatosis, NOS] only when the diagnosis is stated to be meningiomatosis, or multiple meningiomas.
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. |
2006 | |
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20061131 | CS Lymph Node Examined--Lung: How is this field coded when a mediastinoscopy and lobectomy are performed and the pathology report indicates multiple lymph node fragments were removed as biopsy specimens and the lobectomy specimen revealed 3 interlobar lymph nodes? | 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 the CS Lymph Node Examined field to 98 [number unknown] because the biopsy information is not clear and as a result you do not know how many lymph nodes were examined. |
2006 |
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