| Report | Question ID | Question | Discussion | Answer | Year |
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20031001 | EOD-Extension/EOD-Lymph Nodes--Cervix: How do you code these fields when the cancer extended to the pelvic wall and there are periaortic LN metastases? | For cases diagnosed 1998-2003: Assign extension code 65 for contiguous (direct) extension of tumor from the cervix to the pelvic wall. Assign extension code 85 only if the pelvic wall is involved with discontinuous extension from the cervix; i.e., the cervical tumor spread indirectly (through lymph or vascular channels) to the pelvic wall. Code the pelvic wall involvement in the Extension field and the periaortic lymph node involvement in the Lymph Node field. When the computer does the algorithm, it will look at the periaortic lymph nodes and report the summary stage as distant and the TNM stage group as IV because periarotic nodes are M1. Do not code the periaortic lymph nodes in both fields. This is stage IV, distant disease, due to the periaortic lymph node involvement (EOD lymph nodes code 6). |
2003 | |
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20031072 | EOD-Pathologic Extension--Prostate: Is extracapsular extension implied by the phrase "tumor invades the fibrous tissue of the capsule"? See Description. |
The physician staged to a pathology stage of T3. It appears the physician regards the following pathology statement to be equivalent to capsular invasion on the right side: "Tumor invades the fibrous tissue of the capsule on the right side where it approaches to within 1 mm. of the surgical margin." Should pathologic extension be coded to 42[unilateral extracapsular extension]? |
Use the best information available to stage the case. In this case, the best information is the pathologist's description of the tumor extension rather than the AJCC stage. For cases diagnosed 1995-2003: Extracapsular extension is not implied by the phrase in the question. Code the capsular involvement described to 32 [invasion into but not beyond the prostatic capsule] on the basis of the pathology report. |
2003 |
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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 |
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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 |
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20031170 | Terminology, NOS/Recurrence/Multiple Primaries (Pre-2007): Is the term "residual disease" equivalent to "recurrence"? See Description. | Example 1. Patient underwent excision and re-excision of lentigo maligna in 1998. Final path showed close but negative margins. In 1999 a biopsy of a brown patch (over the scar) in the same location was done. Pathology reported residual lentigo maligna. Is the 1999 melanoma a new primary because it was diagnosed more than two months after the first melanoma and there is no mention of recurrence? Or is the term "residual" another way of saying recurrence? Example 2. In 1999, patient underwent excisonal biopsy of intraductal carcinoma of the right breast, followed by radiation therapy. In 2000, mammogram showed calcifications in right breast. Biopsy was done with path showing residual ductal carcinoma in situ. There is no mention of recurrence. Is this one or two primaries? |
For tumors diagnosed prior to 2007:
According to our pathologist consultant, "residual" disease indicates incomplete eradication of the original disease process. Residual means that the disease process was not completely removed/eradicated in the initial therapy. Therefore cells from the original primary were never completely removed or destroyed. In each example above, this is not a recurrence per se but rather progression of disease. Do not abstract the latter diagnosis as a new primary.
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 |
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20031033 | Grade, Differentiation--Hematopoietic: Is this field coded to 6 [B-cell] from a flow cytometry that specifies the percentage of B-cells that exist within the percentage of lymphoid cells in the bone marrow biopsy? See Description. | Bone marrow biopsy, Final path diagnosis: consistent with small lymphocytic lymphoma/chronic lymphocytic leukemia. Comment: flow cytometry analysis was performed on bone marrow aspirate. The gated population of lymphoid cells comprises approximately 19% of total nucleated cells. Of these, 53% are B-cells which express CD19, CD22. These findings are consistent with the above diagnosis. | For cases diagnosed prior to 1/1/2010:Yes, assign code 6, B-cell. The flow cytometry analysis confirms B-cell. For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2003 |
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20031169 | Laterality--Head & Neck: Does the site code C098 need a laterality code? See Description. |
In the SEER EOD-88 3rd edition, page 36, site code C098 does not need laterality. In the SEER Program code manual, 3rd edition, page 93, site code C098 is listed as a site that needs a laterality code 1-9. | Topography code C098 [Overlapping lesion of tonsil] requires a laterality code of 1-9. Follow the laterality guidelines in the SEER Program Code Manual. | 2003 |
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20031192 | EOD-Extension--Breast: How is this field coded when the diagnosis includes both invasive and in situ disease, and the pathology report stated the tumor size may or may not include the size of the in situ portion of the tumor? See Description. | Examples:
1. Invasive ductal carcinoma well differentiated, 1.2 cm, gross tumor size, ductal carcinoma in situ.
2. Gross tumor size 3.2 x 2.5 x 2.3 cm. well differentiated to moderately differentiated invasive ductal ca, accompanying component well differentiated ductal carcinoma in situ, solid, cribiform. |
For cases diagnosed 1998-2003: Use extension codes 16, 26, or 36 depending on extent of involvement. These codes indicate that invasive and in situ components are present, the size of the entire tumor is coded in Tumor Size, the size of the invasive component is not stated, and the proportions of in situ and invasive are not known. Both examples above measure the entire tumor including invasive and in situ components. Assign extension code 16, unless there is evidence of further involvement. |
2003 |
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20031171 | Reportability: Is pseudomyxoma peritonei always reportable? See Description. | In the ICD-O-3, pseudomyxoma peritonei has a behavior code of 6, indicating that it is malignant. Does this imply that pseudomyxoma peritonei is always a reportable malignancy? In the past, our pathologist consultant told us that pseudomyxoma peritonei is only a reportable malignancy if the underlying tumor is malignant. A benign cystadenoma of the appendix, for example, can rupture causing pseudomyxoma perionei. Does SEER agree with our pathologist consultant? Example: Patient was found to have psuedomyxoma peritonei. Right hemicolectomy was done. Path reported an appendix with mucinous cystic tumor of undetermined malignant potential. A definite diagnosis of cancer can not be rendered. |
Reportability is determined from the behavior of the primary tumor and the behavior of implants. If either are malignant, the case is reportable. The case example does not seem to be reportable, based on the available information. Cancer diagnosis has not been made according to the pathology report. |
2003 |
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20031006 | EOD/Surgery of Primary Site--Melanoma: If a melanoma primary site is other than skin, vulva, penis, or scrotum should these fields be coded using melanoma schemes? See discussion. | Should a melanoma of the cervix be coded using the melanoma or the cervix schemes for these fields? | For cases diagnosed 1998-2003: Use the EOD and surgery code schemes for cervix uteri. The EOD scheme for melanoma excludes melanoma of the cervix uteri. The surgery code scheme for skin excludes cervix uteri. | 2003 |
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