| Report | Question ID | Question | Discussion | Answer | Year |
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20051049 | Reportability/Primary Site--Head & Neck: If a wedge resection/shield resection is performed on the lower lip for SCCA and the path report refers to "lip, NOS" with no mention of vermilion border, is this case reportable? | Review the operative and pathology reports, and the physical exam for mention of "mucosal surface" (reportable) or "skin" (not reportable). If neither are mentioned, lip, NOS is reportable per the ICD-O-3 code of C009. | 2005 | |
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20051133 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How are the number of primaries, histologies and CS extension fields coded for breast tissue that contains separate areas of invasive ductal carcinoma, intraductal carcinoma and Paget disease? See Discussion. | Excisional biopsy of a breast mass: 1.0 cm tumor that was infiltrating ductal carcinoma, high grade, with an associated intraductal component with comedonecrosis. Pathology report for the mastectomy three weeks later: no residual tumor was found near the original biopsy site. In another portion of the same breast was found high-grade intraductal carcinoma involving the nipple ducts, with Paget Disease of the nipple. (No size was given for this.) |
For tumors diagnosed prior to 2007:
This is a single primary. According to Exception 3 of Multiple Primary Rule 6 for multiple tumors, combinations of Paget disease and ductal carcinoma are a single primary. The histology code for this case is 8541 [Paget disease and infiltrating duct carcinoma]. Assign CS extension code 10 [confined to breast tissue] based on the information above.
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. |
2005 |
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20051035 | Reportability--Brain and CNS: Does a case of astrogliosis meet the criteria for gliomatosis cerebri? See Discussion. | Case clinically stated to be a glioma of the brain. Pathology from resection states astrogliosis. Anderson's Pathology defines astrogliosis as astrocytic proliferations. Gliomatosis cerebri is defined as diffuse neoplastic transformation of poorly differentiated astrocytes over a wide area; predominantly invovles hemispheric white matter. |
The pathologic diagnosis for this case, astrogliosis, is not reportable to SEER. Take the definitive diagnosis for this case from the pathology report from the resection. The pathology report takes precendence over the clinical diagnosis. | 2005 |
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20051088 | 2004 SEER Manual Errata/Surgery of Primary Site--Lymphoma: Item 9.a on page 178 is incorrect. Do not assign surgery code 98 to lymphoma, primary in lymph nodes. See Appendix C, page C-707 for Lymphoma (primary in lymph nodes) surgery codes. | Delete item 9. a. i. ii. and iii. on page 178 of the 2004 SEER Manual. This correction will be included in the next errata. | 2005 | |
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20051103 | CS Extension/Histology (Pre-2007)--Melanoma: When do the terms "regression is present," "apparent regression," or "undergoing regression" affect the coding of melanoma cases? See Discussion. | For melanoma, many path reports document the presence or absence of regression. At what point does the presence of regression become significant enough to code it for histology and for CS Extension?
Example 1: Skin biopsy showed malignant melanoma, Breslow thickness 0.38 mm, Clark's level II, ulceration is absent, regression is present. Example 2: Punch biopsy showed malignant melanoma, Clark's level II, 0.34-mm maximum depth of invasion, with apparent regression. Example 3: Skin biopsy showed lentigo maligna undergoing regression. |
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 tumors diagnosed prior to 2007:
Regression does not affect CS staging for cutaneous melanoma. "Malignant melanoma, regressing" [8723] is coded only when it is the final diagnosis. Do not use code 8723 for the examples above. According to our pathologist consultant: Melanoma can occasionally undergo "spontaneous" regression -- the tumor can become smaller, and in some cases even disappear. This phenomenon is likely due to an increased immune response on the part of the "host" (person with the melanoma). This is noted occasionally in patients with metastatic disease which gets smaller, or even disappears. We think this is also what has happened in patients who get diagnosed with metastatic melanoma, say in a lymph node, but have no primary tumor, though sometimes give a history of a skin lesion which came and then went away, or a skin lesion which was not submitted for pathological examination. In addition, we (pathologists) occasionally see biopsies which have melanoma as well as the presence of the immune reaction to it, and once in a while, the immune reaction with little or no evidence of residual melanoma. The College of American Pathologists says that regression of 75% or more of the melanoma carries an adverse prognosis.
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. |
2005 |
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20051022 | Primary Site--Breast: Would a tumor described as located "lower central" be coded to C501 (central) or C508 overlapping (lower)? | Code the primary site C501 [Central portion of breast]. Based on the description above, the tumor is located in the central portion of the breast. | 2005 | |
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20051023 | Reportability/Recurrence (Pre-2007)--Bladder: If a patient has had recurrent invasive bladder cancers since 1971, should the latest recurrence in 2003 be SEER reportable because the case has yet to be reported to SEER? |
For tumors diagnosed prior to 2007: Because this 2003 recurrent bladder cancer was initially diagnosed prior to 1973, it is not reportable to SEER. 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. |
2005 | |
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20051062 | Surgery of Primary Site--Prostate: How is the use of a Laserscope Niagara laser (modulated KTP-YAG laser beam (Niagara 122 prostate vaporization)) coded for prostate primaries? See Discussion. | The Laserscope Niagara laser performs an operation similar to the TURP, but there is virtually no bleeding and patients can sometimes go home the same day, most without a catheter. The laser is delivered through a fiber (the thickness of hair) into the cavity via an endoscope inserted through the urethra. | When performed as part of the first course of therapy, assign surgery code 15 [Laser ablation] to Niagara laser photovaporization of the prostate. | 2005 |
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20051127 | Reportability--Brain and CNS: Is an "intradural extramedullary schwannoma (neurilemoma)" of the spine reportable? See Discussion. | Example: Pt underwent laminectomy and excision of intradural extramedullary tumor. Is there a default decision for tumors described as intradural extramedullary tumors, NOS? |
For cases diagnosed 2011 and later: A spinal "intradural extramedullary schwannoma (neurilemoma)" is reportable. This schwannoma originated in the spinal nerve root, C720.
See #2 under Reportability in the Data Collection Answers from the CoC, NPCR, SEER Technical Workgroup, http://www.seer.cancer.gov/registrars/data-collection.html#reportability |
2005 |
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20051086 | CS Site Specific Factor 4--Prostate: For apex involvement at prostatectomy, is only apical involvement found at prostatectomy included or is all histologically proven apical involvement documented in the second digit of Site Specific Factor 4? See Discussion. | Per note 1 for Site Specific Factor 3 - Pathologic Extension all histologic information is used. Biopsy information would be included when coding path extension. Would all histologic information be used for coding prostatectomy apex involvement in Site Specific Factor 4? Example 1: Prostate biopsies of the right and left apex and right and left mid gland show adenocarcinoma. Prostatectomy shows bilateral adenocarcinoma. Apex negative for tumor. Example 2: Prostate biopsies of right apex and mid gland show adenocarcinoma. There is no mention of apex on prostatectomy path. How is CS Site Specific Factor 4 Prostate Apex Involvement coded? |
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 the second digit of CS SSF 4 based on prostatectomy only, do not include biopsy or other histologic information in the second digit. According to the CS Steering Committee, the clinical or biopsy of the prostate is included in the first number of the code and should not be combined with the prostatectomy code which is the second number. These were separated purposely. Example 1: Code the second digit of SSF 4 based on the prostatectomy, 1 [no involvement of prostatic apex]. Example 2: Code the second digit of SSF 4 based on the prostatectomy, 5 [apex extension unknown]. |
2005 |
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