| Report | Question ID | Question | Discussion | Answer | Year |
|---|---|---|---|---|---|
|
|
20051038 | First Course Treatment--Prostatic Urethra: Is Lupron coded for a papillary carcinoma of the prostatic urethra that is treated with a TUR with fulguration and beam radiation even though the prostate biopsies are negative? | Do not code lupron as treatment for a primary in the prostatic urethra. | 2005 | |
|
|
20051040 | Primary Site--Sarcoma: What is the correct topography code for a partial lung lobectomy with pathology diagnosis of "pulmonary sarcoma with smooth muscle differentiation"? See Discussion. | Operative report: palpable 2x2cm mass in the mediastinal surface of the rt middle lobe and the contiguous upper lobe together.
Path comment after partial lung lobectomy: In all likelihood this is a malignant process occurring in smooth muscle changes surrounding vessels within the lung versus an undifferentiated epithelial tumor.
ADDENDUM DX: low grade pulmonary sarcoma with smooth muscle differentiation.
Consultant's report concurs with that of the original pathologist's report of malignant neoplasm compatible with smooth muscle origin. |
This case is unique. Assign topography code C493 [Connective, subcutaneous and other soft tissue of thorax]. Based on the information provided, this sarcoma has smooth muscle differentiation and originated in the muscle. Code the primary site to muscle. | 2005 |
|
|
20051039 | 2004 SEER Manual Errata/Cancer-Directed Therapy: Is the phrase "cancer directed therapy" still applicable? | Remove the phrase "cancer-directed therapy" from pages 174 and 175 of the 2004 SEER manual. | 2005 | |
|
|
20051120 | CS Eval--Colon: Should 1 [No surgical resection done...] or 3 [Surgical resection performed...] be used to correctly reflect this field when a surgical observation is "adherent to duodenum" but the extension per the pathology is stated to be to the "subserosal tissue"? See Discussion. | 7/2/04 Op Findings 5 cm mass in mid transverse colon involving also the right colon; mass was adherent to duodenum without obvious invasion. 7/2/04 Path: Rt & Transverse Colon: 6x5 cm mass, micro: MD Adenoca with invasion of subserosal tissue; margins neg. 17/17 colic LNs negative. | 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 the case described above, code extension as 46 [Adherent to other organ...no microscopic tumor found in adhesion]. Code CS TS/Ext eval as 3 [Surgical resection performed...]. Surgery was performed for this case. The fact that the adherence to the duodenum was proven not to be tumor involvement should be coded as 3 in CS TS/Ext Eval. By using eval code 3, the case will map to a pathologic T indicating that the patient had resective surgery. Eval code 1 would map to a clinical T, incorrect for this case. |
2005 |
|
|
20051001 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Lung: How is histology coded for the tumor(s) that exist if a left upper lobe of lung resection final diagnosis states the patient has a moderately differentiated adenocarcinoma and the path indicates there are "multiple carcinoid tumorlets"? | For tumors diagnosed prior to 2007:
Histology is coded 8140/3 [adenocarcinoma]. This is one reportable tumor of the left lung. According to our pathologist consultant, the tumorlets are collections of cells which appear to be of neuroendocrine origin, but are not malignant.
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 | |
|
|
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 |
|
|
20051002 | CS Tumor Size/CS Site Specific Factor 6--Breast: How are these fields coded for a tumor stated to have only in situ disease in the breast with bone metastasis identified on scan? See Discussion. | 4/20/04 Quadrantectomy: "Tumor involves a significant portion of the biopsy and is estimated at 10 cm in greatest dimension." The only other mention of size is from imaging studies which is 3.5 cm. The histology is "high grade ductal carcinoma with comedo necrosis. No invasive carcinoma identified." Bone scan on 4/20/04 shows "widespread metastatic disease to bone." By rule the behavior code for this case is changed to malignant. | 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 tumor size as 100 [10 cm]. Size from pathology or operative report is preferred over size from imaging.
Code SSF6 as 050 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated and proportions of in situ and invasive not known.]
There is invasive tumor present (as proven by the bone metastasis), but the size and proportion of the invasive component is unknown.
Please note: Extension must be coded at least to 10 [Confined to the breast tissue and fat including nipple and areola; Localized, NOS] in this case. Do not assign extension code 00 [in situ]. |
2005 |
|
|
20051131 | Recurrence/Multiple Primaries (Pre-2007)/Primary Site--Breast: Is a malignancy that occurs in 2005 in a mastectomy scar years following an original diagnosis of breast cancer in 1971 a recurrence (not reportable) or a new primary (breast or chest wall, NOS)? See Discussion. |
The patient had a right mastectomy for breast carcinoma in 1971. In 2005, she came in with a mass in the right axilla and a right chest wall mass in the mastectomy scar. Excision of the axillary mass and biopsy of the chest wall mass revealed invasive adenocarcinoma with a similar histologic pattern. The axilla specimen contained no benign breast tissue. IHC stains exhibit strongly positive for ER, mildly positive for PR and negative for HER2/neu. The pathologist says "Although these findings are consistent with recurrent breast carcinoma, they are not specific for such. Recurrence after 34 yrs. is most unusual." |
For tumors diagnosed prior to 2007: The 2005 diagnosis is a new primary. The 1971 site differs from the 2005 site and there are more than two months between the two. Without further information, assign topography code C761 [chest wall]. The pattern of spread, including regional extension, is different for a primary of the chest wall compared to a primary in the breast. Coding the primary site to C761 will group this case with similar cases. If further information can be obtained, look for old records that describe the extent of the 1971 mastectomy. It is possible that there was breast tissue left on the chest wall. Residual breast tissue is often present following mastectomy (simple, modified, or even radical). New carcinoma can develop in the remaining breast tissue. 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 |
|
|
20051011 | CS Lymph Nodes/CS Site Specific Factor--Breast: When there are no lymph nodes removed and none palpable for an inflammatory breast cancer and the physician stages the case Nx, is the CS Lymph Node field code to 00 [None, no regional lymph nodes involved] or 99 [Unknown, not stated] and would SSF 4 and 5 be coded to 000 [Regional lymph nodes negative...] or 888 [Not applicable]? | 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 Lymph Nodes 00 [clinically negative]. See note 3 for CS Lymph Nodes. Code SSF 4 and 5 000 [Nodes clinically negative]. |
2005 | |
|
|
20051115 | Histology (Pre-2007)--All Sites: How are "malignant cells" in a cytology or "probably malignancy" in a CT scan coded? | For tumors diagnosed prior to 2007:
Assign code 8001/3 [Tumor cells, malignant] when the only information available is a cytology report stating "malignant cells." Assign code 8000/3 [Neoplasm, malignant] when then only information available is a CT report stating "probable malignancy." See ICD-O-3 page 27 for an explanation of "cancer" [8000] and "carcinoma" [8010].
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 |
Home
