Report | Question ID | Question | Discussion | Answer | Year |
---|---|---|---|---|---|
|
20041087 | CS Extension--Head of Pancreas: What code is used to represent extension to the superior mesenteric artery? See Discussion. | In the CS coding scheme for Head of Pancreas, superior mesenteric artery is listed under both code 54 (T3) and 60 (T4). | 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 code 60 for a primary in the head of the pancreas extending to the superior mesenteric artery. CS Extension code 54 should be Superior mesenteric VEIN and code 60 should be Superior mesenteric ARTERY. An errata will be issued by CS. In addition, extension 54 indicates resectable disease and code 60 is not resectable. |
2004 |
|
20041018 | Grade, Differentiation: Can grade be assigned based on a thin prep if there is no grade in the other pathology reports? See Discussion. | Example:
Vag & Cervical Thin-Prep: Adenocarcinoma, endometrial, high grade.
Resected Uterus and Left Adnexa: Endometrial papillary serous carcinoma arising in an endometrial polyp. |
When it is the only source specifying the grade, code grade from the thin prep. | 2004 |
|
20041084 | Multiple Primaries (Pre-2007)--Vulva/Vagina: In 2004 if multiple biopsies reveal VAIN III of the vaginal wall, and VIN III of the left fourchette and the right labia minora is thisĀ one primary per the SEER Site Grouping Table on page 9 of the 2004 SEER Manual because vulva and vagina are supposed to be abstracted as a single site? |
For tumors diagnosed prior to 2007: Abstract the case above as one primary according to multiple primary rule 3a. Code the primary site to C579 [Female genital, NOS] according to the table on page 9 of the 2004 SEER Manual. Multiple tumors of the same site and same histology diagnosed at the same time are abstracted as one primary. Multiple independent tumors of the vulva and vagina are abstracted as a single site when diagnosed simultaneously. VAIN III and VIN III have the same histology code [8077]. 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. |
2004 | |
|
20041086 | Histology (Pre-2007)/CS Tumor Size/CS Extension--Colon: How are these fields coded if a 3 cm sessile polyp is snared and removed piecemeal during a colonoscopy and the path microscopic description indicates a polypoid lesion with foci of malignant transformation found associated with bundles of smooth muscles followed by a LAR with no residual invasive tumor but the final path diagnosis is stated to be a M.D. adenocarcinoma? See Discussion. | 3/04 colonoscopy 3cm sessile polyp snared & removed piecemeal. Path Micro: Polypoid lesion consists of branching & complex neoplastic glands lined by tall columnar epithelial...These foci of malignant transformation are assoicated with large polygonal epithelial...associated with desmoplastic stromal reaction & neoplastic glands can be found associated with bundles of smooth muscle. 4/04 LAR: focus of residual HG dysplasia: no residual invasive tumor. Final path dx: MD adenocarcinoma. Physician staged: T2 N0 M0. Histology: 8140 vs 8210 Tumor Size: 030 vs 999 vs 990 Extension: 12 vs 20 |
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 information provided: Histology: 8210 [Adenocarcinoma in a polyp] Tumor Size: 999 [Unknown] CS Extension: 20 [Muscularis propria invaded]
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. |
2004 |
|
20041050 | Surgery of Primary Site--Rectum: How do you code a procedure described as a "transanal resection, debulking of a large rectal mass"? See Discussion. | Patient is not a surgical candidate due to "other medical conditions". Colonoscopy done for anemia and rectal bleeding. At the colonoscopy a "Transanal Resection Debulking of large rectal mass" is performed. Two specimens are sent to the lab. The first is labeled "rectal mass" and is a 2.0 cm diameter spherical fragment of tissue. The second is labeled "transanal debulking rectal mass" and is described as multiple, irregular shaped fragments of tan, rubbery tissue measuring 5.0 x 5.0 x 3.0 cm. Final path diagnosis: Debulking of rectal mass: Adenocarcinoma greater than 2 cm in size, resection margins positive for tumor. | For cases diagnosed 1998-2002, code Surgery of Primary Site to 20 [Local tumor excision, NOS]. Because the procedure was performed via colonoscopy and apparently did not involve proctectomy, the best choice is a local excision. | 2004 |
|
20041025 | Immunotherapy/Chemotherapy: Are monoclonal antibodies, such as Avastin and Erbitux, coded as immunotherapy or chemotherapy? See Discussion. | In review of the "FDA-approved oncology agents not listed in SEER Book 8" provided in 5/02, it appears "monoclonal antibodies" are coded as immunotherapy. | Code Avastin and Erbitux as chemotherapy because both of these drugs are growth inhibitors. Code growth inhibitors (cytostatic agents) as chemotherapy. Do not assume that monoclonal antibodies are coded as immunotherapy. | 2004 |
|
20041097 | Reportability--Brain and CNS: Is a skull tumor schwannoma an intracranial reportable benign tumor if the physician states it arose in the occipital nerve? |
No. These schwannomas are not intracranial and therefore, are not reportable to SEER. The occipital nerve is not one of the 12 intracranial nerves (i.e., Abducens, Auditory (vestibulocochlear), Facial, Glossopharyngeal, Hypoglossal, Oculomotor, Olfactory, Optic, Spinal Accessory, Trigeminal, Trochlear, and Vagus). |
2004 | |
|
20041088 | CS Extension/EOD Extension--Renal Pelvis: Primary site is renal pelvis with direct extension to the rt adrenal gland. What is the correct extension code? | 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 Extension code 67 [Adrenal gland from renal pelvis] for adrenal extension from renal pelvis -- T4 and regional direct extension. |
2004 | |
|
20041091 | Primary Site/Summary Stage 2000/EOD-Extension--Lymphoma: How are these fields coded when a CT Impression states: Large retroperitoneal/abdominal mass resulting in extra-hepatic biliary obstruction & bilateral urinary tract obstruction & encasement of major vessels most c/w lymphoma? See Discussion. | CT findings state: Very lg sft tiss mass encasing pancreatic head & portion of body, splenic & portal veins, celiac axis, sup mesenteric artery & bilateral renal veins. Two components to this mass: 1) retroperitoneal mass encasing great vessels and 2) peritoneal component 10.8cm size, displaces bowel & other structures & encases vessels.
If the physician stated "this is bulky disease" would that change the EOD? |
For tumors diagnosed 1998-2003:
Based on the information provided: The topography code for this lymphoma is C772 [Intra-abdominal lymph nodes]. Code SEER Summary Stage 2000 to 5 [Regional NOS]. Code EOD Extension to 20. More than one lymph node region below the diaphragm is involved (retroperitoneal and peritoneal). The organs mentioned are not involved by the lymphoma. The bulk of the masses is causing obstruction by displacing and/or encasing organs. A physician description of "bulky disease" would not change the EOD for this case. |
2004 |
|
20041076 | CS Extension--Colon: What is the difference between codes 46 [Adherent to other organs or structures, but no microscopic tumor found in adhesion(s)] and 57 [Adherent to other organs or structures, NOS]? See Discussion. | Code 46 reads "Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)". Would these examples be coded to 46? Example 1: 7/04 Op findings: mass was adherent to duodenum without obvious invasion. Path: margins negative (no mention of duodenum). Case staged to pT3. Example 2: Op findings: large mass involving cecum adherent to peritoneum & retroperitoneum. Path: invasion of pericolic soft tissue; margins negative (no metion of peritoneum & retroperitoneum). Case staged to pT3. |
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 46: Attached to other organ (on imaging or surgical observation); pathology says no invasion of the other organ. Code 57: Attached to other organ; pathology is positive for invasion of other organ, or pathology does not specify whether there is invasion of the other organ. Example 1: Code extension to 46 [Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)]. The tumor was attached to the duodenum, but not invading Example 2: Code extension to 46 [Adherent to other organs or structure, but no microscopic tumor found in adhesion(s)]. The tumor was attached to peritoneum & retroperitoneum, but not invading based on negative margins and no peritoneum or retroperitoneum specimen submitted to pathologist. |
2004 |