Ambiguous Terminology/Reportability: Are the terms "bordering on" and "may represent" diagnostic of cancer? See Discussion.
Pathology report states "...florid micropapillary hyperplasia, focally atypical with features bordering on low grade micropapillary ductal carcinoma in situ."
The terms "bordering on" and "may represent" are not diagnostic of cancer. These terms are not on the list of ambiguous terms that constitute a diagnosis of cancer. The diagnosis in the example above is not reportable to SEER.
Multiple Primaries (Pre-2007)/Date of Diagnosis--Bladder: How is date of diagnosis coded when metastases consistent with a bladder primary are found more than a year after a diagnosis of non-invasive bladder cancer? See Description.
A non-invasive papillary transitional cell carcinoma is removed by TURB in May 2002. In January 2003, a bone biopsy reveals metastatic transitional cell carcinoma consistent with bladder primary.
For tumors diagnosed prior to 2007:
Code a second bladder primary diagnosed in January 2003.
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.
Surgery of Primary Site/Surgery codes, NOS--Colon: What tissue specimens are included under this field's code 41 [Subtotal colectomy/hemicolectomy plus resection of contiguous organ; example: small bowel, bladder]? See Discussion.
How is site specific surgery coded for the following two cases?
Example 1. A right hemicolectomy normally includes a portion of ileum.
Example 2. Subtotal colectomy with bilateral oophorectomy.
Code 40 includes a right hemicolectomy. A right hemicolectomy normally includes a small portion of the terminal ileum removed with the ileocecal valve. Assign code 41 when resection of CONTIGUOUS organs goes beyond what would normally be removed as part of a subtotal colectomy/hemicolectomy. Record non-contiguous organ resection in Surgical Procedure of Other Site.
Example 1: Surgery of Primary Site -- 40 [Subtotal colectomy/hemicolectomy].
Example 2: Surgery of Primary Site -- 40 [Subtotal colectomy/hemicolectomy]. Surgical Procedure of Other Site -- 2 [Non-primary surgical procedure to other regional sites].
Addendum July 2021
For coding Surgical Procedure of Other Site, see the instructions for determining regional vs distant sites in the 2021 SEER manual under Coding Instructions #6 and #7 on pages 184-185. Do not use Summary Stage to determine regional vs distant for this data item.
Histology (Pre-2007)--Lung: What is the correct histology code for this case of squamous cell carcinoma with several different variants? See Discussion.
The path report from a left pneumonectomy says: This squamous cell carcinoma had several different variants present including typical non-keratinizing squamous cell, spindled cell squamous cell, clear cell squamous cell and a small cell variant of squamous cell.
I cannot find a combination code that fits; the majority of the tumor is not stated; so do you code the highest specific type mentioned - 8084 - Squamous cell, clear cell type?
For tumors diagnosed prior to 2007:
Assign histology code 8070 [squamous cell carcinoma, NOS]. Squamous cell carcinoma, NOS includes types of squamous cell carcinoma without a specific code. This is a combination squamous tumor that does not have a unique code.
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.
CS Extension/Histology (Pre-2007)--Breast: Paget disease with underlying DCIS. How should CS Extension, SEER Summary Stage 2000, histology, and behavior be 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.
For tumors diagnosed prior to 2007:
Based only on the information provided above,
1. The CS extension code is 07 [Paget disease of nipple (without underlying invasive carcinoma pathologically)].
2. The SS 2000 stage is 1 [Localized].
3. The histology code is 8543 [Paget disease and intraductal carcinoma of breast]. The behavior code is 3 [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.
CS Extension/CS Mets at Dx--Lung: How are these fields coded for bilateral pleural effusion for a right lung primary? A code of 72 in the CS Extension field leads to a T4, but bilateral pleural effusion is M1. Should CS Mets at Dx be coded 39?
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 bilateral malignant pleural effusion, code the ipsilateral malignant effusion in CS Extension and the contralateral malignant effusion in CS Mets at Dx. Assuming the bilateral pleural effusion is the furthest extension in this case, code CS Extension to 72 [Malignant pleural effusion]. Code CS Mets at Dx to 40 [Distant mets, NOS].
EOD-Extension--Sarcoma: How is this field coded for a soft tissue sarcoma that involves the overlying skin?
For cases diagnosed 1998-2003: It depends on the location of the soft tissue sarcoma. If the tumor is very superficial, code EOD-Extension to 60 [Adjacent organs/structures]. However, if the soft tissue sarcoma is between muscles or "deep" according to the AJCC definition, then it would have to grow through the superficial fascia to get to the skin. In this case code EOD-Extension to 80 [Further contiguous extension].
CS Site Specific Factor 6--Breast: Can we interpret the in situ component as "minimal" when the pathology report states "1.1 cm infiltrating duct carcinoma and no extensive intraductal component"?
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. Based on the information provided above, the in situ component is "mininmal" for the purpose of coding Breast CS Site Specific Factor 6. The phrase "no extensive intraductal component" suggests that there is some intraductal carcinoma present.
Histology (Pre-2007)--Colon: Must a case be specifically labeled "familial adenomatous polyposis" or is the mere presence of numerous/multiple polyps sufficient for coding the histology to FAP?
For tumors diagnosed prior to 2007:
The presence of numerous/multiple polyps is not necessarily adenomatous polyposis coli. Adenomatous polyposis is an extreme condition usually characterized by the presence of hundreds of polyps and should be identified as such either clinically or pathologically.
Look for the term "Familial adenomatous polyposis," FAP or one of its synonyms:
Adenomatosis of the colon and rectum [ACR]
Familial adenomatous colon polyposis
Familial colonic polyposis
Multiple familial polyposis
In the absence of these terms, the following probably indicate a diagnosis of FAP:
Hundreds of adenomatous polyps throughout large intestines, and at times, throughout the digestive system
Development of polyps as early as ten years of age, but more commonly at puberty
History of colectomy
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.
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