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Report Produced: 02/12/2026 04:43 AM

Report Question ID Question Discussion Answer Year
20031154 Date of Diagnosis/Histology (Pre-2007)/Behavior--Melanoma: How are these fields coded when the first shave biopsy finds "what appears to be the top of a melanoma" and a subsequent shave biopsy finds "features consistent with lentigo maligna?"

For tumors diagnosed prior to 2007:

Evaluate each case using all available information, including all pathology reports. Use the date of the first biopsy because it did identify the melanoma. The second biopsy confirmed the histologic type.

According to WHO's Histological Typing of Skin Tumors, lentigo maligna melanoma is similar to lentigo maligna, but has dermal invasion by atypical melanocytes.

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.

 2003
20031042 Histology (Pre-2007): How are the following four histologies coded: 1) Adenocarcinoma with focal mucinous adenocarcinoma; 2) Adenocarcinoma with focal areas of bronchioalveolar adenocarcinoma, 3) Mixed infiltrating duct and focal medullary carcinoma, and 4) Mixed infiltrating duct and focal medullary carcinoma? See Description.

1. How do we code colon: Adenocarcinoma with focal Mucinous adenoca? 8140/3 or 8255/3?

2. A lung lesion with predominant adenoca with focal areas of bronchioalveolar adenoca? 8140/3 or 8255/3?

3. Mixed infiltrating duct carcinoma and medullary ca? 8510/3 or 8255/3?

4. Mixed infil duct ca and focal medulary ca? 8510/3 or 8255/3?

For tumors diagnosed prior to 2007:

1. 8140/3, Adenocarcinoma. Mucinous has a specific rule (see sinq 20010075): Include the mucinous component only if it is 50% or more of the tumor. "Focal" is not a majority term.

2. 8250/3, Bronchiolo-alveolar adenoca. Code the more specific histology.

3. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

4. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

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.

 2003
20031153 Laterality/Multiple Primaries (Pre-2007)--Ovary: Are ovarian primaries with bilateral involvement always coded to laterality 4 (bilateral)? See Description. Example: "Right ovary with mass replacing majority of ovarian tissue consistent with serous adenoca. Lt ovary with foci of adenoca." No specific statement of primary. Can we assume that the malignancy originated in the right ovary since it is more extensively involved or should laterality be coded 4 because both ovaries have tumor?

For tumors diagnosed prior to 2007:

If one ovary is listed as the primary site, code laterality to that ovary. The example above is one of those times when you would code to the single ovary. The issue of one or both ovaries being involved is handled in staging.

Abstract the example above as a single primary with code 1 [Right] for laterality.

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.

 2003
20031199 CS Extension/Polyp--Colon: How is CS extension coded for tumor invasion described as "Haggitt level 4"? See Description. Polypectomy specimen revealed adenocarcinoma of the rectum in a tubulovillous adenoma. Per path extent of invasion was Haggitt level 4. The micro description of the tumor stated that there was malignant epithelial neoplasm in colonic mucosa.

In a 1985 Gastroenterology journal article, Haggitt described five levels of polyp invasion:

Level 0-confined to mucosa

Level 1-head

Level 2-Neck

Level 3-Stalk

Level 4-Submucosa of underlying colonic wall.

For cases diagnosed 2004 and forward:

Use the best information available to code CS extension. The following conversion may be used when the only information available is the Haggitt level.

Level 0 - Extension 10

Level 1 - Extension 13

Level 2 - Extension 15

Level 3 - Extension 14

Level 4 - Extension 16

 2003
20031114 EOD-Extension--Colon: How is this field coded for an appendical primary when the appendix has ruptured and intrapentoneal fluid is positive? For cases diagnosed 1998-2003: Code EOD extension as 85 [Metastasis]. Positive intraperitoneal fluid is equivalent to distant metastasis (implantation) for colon, including appendix, primaries. 2003
20031071 EOD-Extension--Brain and CNS: How does one code this field for a brain primary with drop metastases and/or seeding? See Description.

In the past SEER has advised coding these cases to extension 60. However, SS2000 states to code these cases to distant.

1. Primary in the cerebrum, hypothalamic region, with drop mets to spinal cord.

2. Primary in the cerebellum with spinal cord drop mets.

3. Primary in the fourth ventricle, with drop mets along the spinal cord.

For cases diagnosed 1998-2003: Assign extension code 85 [Metastasis] for drop metastases and/or seeding of the spinal cord from a brain primary.

Assign code 85 to each of the three cases above.

 2003
20031205 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: How are these fields coded when an autopsy report reveals pathologically involved regional lymph nodes but does not state how many nodes were positive nor how many were examined? See Description. A final autopsy report described widely disseminated adenocarcinoma, probably lung primary. Metastatic tumor in brain, lungs, and in lymph nodes. The Gross description of the autopsy report stated that there were numerous metastases to hilar and mediastinal lymph nodes. The Micro description of the autopsy report did not add any clarification. In the absence of a stated number of lymph nodes, the options for coding number of regional lymph nodes examined are codes 96-98. These codes include descriptions of surgical procedures such as sampling and dissection. How do we code number of regional lymph nodes examined when the pathological examination of lymph nodes was done only at autopsy and not during a surgical procedure?

For cases diagnosed 1998-2003: The rules that apply to the use of pathology reports for EOD coding also apply to autopsy reports.

When a cancer diagnosis is made and positive lymph nodes are discovered on autopsy, in the absence of a stated number of lymph nodes, code the number of lymph nodes positive to 97 [Positive nodes but number of positive nodes not specified]. Code the number of lymph nodes examined to 97 [Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated]. An autopsy is a dissection.

 2003
20031055

Histology (Pre-2007)/Primary Site/Diagnostic Confirmation: How would these fields be coded for a diagnosis of cholangiocarcinoma based on clinical findings only? See Discussion.

We have a case of reported "cholangiocarcinoma" of the liver diagnosed only by a CT of the abdomen. There is no pathologic confirmation. CT ABD: Heterogeneous liver mass suspicious for cholangiocarcinoma; mass causes right portal & right hepatic vein occlusion & right and left biliary duct dilatation....

Should this be coded to cholangiocarcinoma by radiology alone and should it be liver as primary site?

For tumors diagnosed prior to 2007:

Code according to the prevailing medical opinion in this case. If no further information can be obtained, code as cholangiocarcinoma of the intrahepatic bile duct.

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.

 2003
20031081 Primary Site/EOD-Size of Primary Tumor--Lung: If the only lung mass described in CXR is a "hilar mass," is the primary site coded to C34.9 [Lung, NOS] or C34.0 [Main Bronchus; incl. Carina]? Also, can the size of the hilar mass be used to code the size of tumor field?

Because the only description available is "hilar mass," code primary site as C34.0.

For cases diagnosed 1998-2003: Use size of mass for EOD-Size of Primary Tumor.

 2003
20031017 Reason for No Surgery of Primary Site: Does code 2 [Contraindicated due to other conditions; autopsy only case] or code 1 [ Cancer-directed surgery not recommended] have priority when coding this field for extensive tumors not surgically treated because of existing comorbidities? See discussion.

Example:

Patient has Stage IVA carcinoma of the tongue. The physician states that patient is not felt to be a good surgical candidate secondary to multiple medical frailties. Patient is treated with beam radiation.

In this case, how do we code Reason for No Site Specific Surgery? Do we use code 2 because surgery was contraindicated due to co-existing medical conditions or do we use code 1 because the tumor is very extensive and surgery would probably not be done anyway?

SEER has not established a priority for assigning the Reason for No Surgery of Primary Site codes. Assign the code which best describes the reason surgery was not performed.

Example: Assign code 2, Contraindicated due to patient risk factors. According to the physician, this is the reason that surgery was not performed.

 2003