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Report Produced: 03/29/2026 04:15 AM

Report Question ID Question Discussion Answer Year
20031063 Date of Diagnosis: When the clinical information on a scan indicates a history of cancer, how do you code the month and/or year of diagnosis given these terms: "early in year," "late in year," "2-3 months ago," "7 months ago," "new diagnosis." See Description.

Case 1. Diagnosed with CLL in late 1996. Assumptions: Code the term "late" in the year to December. Date of diagnosis would be coded to December 1996.

Case 2. Diagnosed with CLL in early 1997. Assumptions: Code the term "early" in the year to January. Date of diagnosis would be coded to January 1997.

Case 3. Admitted July 2000. Per H & P, patient was diagnosed with prostate cancer 2-3 years ago. Assumptions: Select the higher number in the range (in this case 3 years) and subtract 3 years from date of admit to calculate year of diagnosis. Code diagnosis month to the month patient was admitted. Diagnosis date would be coded July 1997.

Case 4. Admitted in October 2001. H&P states that colon cancer was diagnosed 7 months ago. Assumptions: Subtract 7 months from date of admit. Code date of diagnosis to March 2001.

Case 5. Admitted in December 2001. Per H&P, patient has CLL, presumably a new diagnosis. Assumptions: Assume the H&P statement of "new" to be equivalent to "recent" and code date of diagnosis to date patient was admitted. In this case, date of diagnosis would be coded to December 2001.

Case 6. Admitted for radical prostatectomy for prostate cancer in March 2001. H&P states that his PSA was 5 in November 2000 and in January 2001, PSA was 5.3. Biopsies showed adenocarcinoma. Assumptions: Assume the biopsy was done the same month as the January 2001 increased PSA. Date of diagnosis would be coded to January 2001.

Case 7. Outpatient bone scan done December 2001. Clinical history on the scan stated patient has history of prostate cancer. The physician was queried about date of diagnosis. Per the physician response, patient was diagnosed in 2001. Assumptions: Assume the bone scan was part of the initial work-up for prostate cancer and estimate the date of diagnosis to December 2001.

SEER agrees that these are reasonable assumptions based on the information provided.

Estimate the month and year of diagnosis using the available information. If the information is not sufficient to make an estimation on the month, code the month of diagnosis as "99." Avoid coding "unknown" for the year of diagnosis.

 2003
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
20031123 Grade, Differentiation--Prostate: Has SEER officially changed the conversion code for Gleason score 7 to grade 3 [poorly differentiated] for cases diagnosed in 2003 or later? For prostate cases diagnosed in 2003 and forward: convert Gleason score 7 to grade 3 [poorly differentiated]. 2003
20031120

Primary site: How is this field coded for a malignant spindle cell neoplasm in a subcutaneous mass of the right knee? See Description.

The pathology report says: Right knee tumor:

A. discrete subcutaneous mass 3.5x5.2x1.4 cm malignant spindle cell neoplasm (see Comment)

B. A focus of subcutaneous malignant neoplasm is identified in the superior resection margin.

C.All other margins are clear.

The comment mentions that the specimen has been sent to Mayo Clinic and the Mayo clinic consult says, "we still believe that the diagnosis of spindle cell carcinoma is correct. Obviously the differential diagnosis involves melanoma and sarcoma also. The results of the immunoperoxidase stains strongly support the prior diagnosis of a carcinoma."

Code the site to C49.2 [Connective, subcutaneous and other soft tissues of lower limb and hip]. The site is a subcutaneous mass. C49 with 8032/3 will not be impossible following the next updates to the SEER edits.

 2003
20031119 EOD-Extension/EOD-Lymph Nodes--Colon: For this primary, under which field are satellite tumor nodules in mesenteric adipose tissue coded? See Description.

Sigmoid colon, low anterior resection: Invasive adenocarcinoma, 5.5 cm greastest dimension, moderately differentiated. Tumor invades through muscularis propria, into mesenteric adipose tissue. No penetration of visceral peritoneum. Proximal, distal, and radial margins free of tumor. Satellite tumor nodule present within mesenteric adipose tissue, 1.5 cm diameter, located 2.8 cm from main bowel wall tumor. Ten lymph nodes identified, with no evidence of metastatic tumor.

Comment: The satellite tumor nodule present within the mesenteric adipose tissue has an infiltrating, irregular contoured appearance and does not appear to represent a previously replaced lymph node. This appears to be a local metastasis with histologic features most commonly associated with venous invasion (see AJCC Cancer Staging Handbook, Sixth Edition, 2002, page 131 for current staging terminology).

 For cases diagnosed 1998-2003: For EOD, each grossly detectable nodule in the regional mesenteric fat is counted as one regional lymph node. 2003
20031118 Primary Site/EOD-Extension--Kaposi Sarcoma: How are these fields coded for localized disease described as "Nodal Kaposi Sarcoma" found on inguinal node biopsy only?

Code the site of involvement as the primary site when no other involvement is documented. For the case above, code C774 [inguinal lymph node] as primary site.

For cases diagnosed 1998-2003: Code EOD-extension as 13 [Visceral].

 2003
20031117

Multiple Primaries (Pre-2007): Are simultaneous tumors of the rectosigmoid junction and rectum counted as two primaries? See Description.

On the same day in 1998, a patient was found to have a T3 adenocarcinoma of the rectosigmoid junction and an in situ adenocarcinoma in a villotubular adenoma in the lower rectum. These would be the same histology if they are in the same site.

Are C199 and C209 the same site? They are listed in ICD-O-2 (pg. xxxvii) and in ICD-O-3 (pg. 36), but they are not listed in the SEER Program Manual on page 9 as the same site. Is this one primary or two?

For tumors diagnosed prior to 2007:

Abstract two primaries for the example above, according to the main rule on page 7 in the SPCM. Rectosigmoid junction (C19) and rectum (C20) are in different 3-digit ICD-O-3 topography code categories. Rectosigmoid junction and rectum are not included in the exceptions to the main rule and, therefore, do not appear on page 9 of the SPCM.

The table on page 9 is not identical to the table in ICD-O-3. Two site combinations are listed in ICD-O-3, but not in the SEER table: C19 (rectosigmoid junction) and C20 (rectum); C40 (bones of limbs) and C41 (other bones). Abstract multiple tumors in the rectosigmoid junction and rectum as separate primaries. Abstract multiple tumors in the bones of the limbs and other bones as separate primaries.

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
20031116

EOD-Size of Primary Tumor: Can the term "filling defect" be used to code tumor size? See Description.

Site: Bladder

CT abd/pelvis: 4 cm filling defect of the bladder encasing jetstream of distal ureter. 2-3 cm lesion may be extension to bladder. KUB: 3-4 cm filling defect within bladder.

Cystoscopy: large bladder tumor with small tumor extending out of the large tumor.

OP Findings: Large tumor on right of bladder extending from bladder neck lateral and posterior

Pathology: TURB: High grade TCC, Grade III with focal lamina propria invasion.

For tumors diagnosed 1998-2003:

Information on size from imaging/radiographic techniques can be used to code size when there is no more specific size information from a pathology or operative report, but it should be taken as low priority, just above a physical exam.

The term "filling defect" from a CT or KUB may be used to code tumor size for bladder in the absence of more reliable size information from path, operative or endoscopic reports.

 2003
20031021 Primary Site--Head & Neck: What is the anatomical distinction among tonsillar fossa, tonsillar pillar, and tonsil NOS? Operative findings describe a right tonsil three times the size of the left tonsil. Tonsil is dissected from the tonsillar fossa. There appeared to be no involvement of tumor below the tonsillar capsule.

The tonsil lies in an indentation called the tonsillar fossa. The tonsillar fossa is bordered on either side by the tonsillar pillars. The tonsillar pillars are part of the supporting structure of the throat opening.

Code C09.9 [Tonsil NOS] as the primary site for the case above.

 2003
20031012 EOD-Lymph Nodes/Extension: How does one code these fields if the clinical level of disease extension prior to neoadjuvant treatment is greater than demonstrated on pathology at time of resection? See discussion. Breast case described clinically as a "breast mass and nodal metastases" which is treated with neoadjuvant chemotherapy and at surgery the lymph nodes are pathologically negative.

For cases diagnosed 1998-2003:

Use the combination of clinical and pathologic information to code EOD for primary site, extension and lymph nodes. Code the more extensive disease. If lymph nodes are positive clinically and not positive after neoadjuvant treatment, code lymph node involvement. If lymph nodes are negative clinically and positive on path, code lymph node involvement. When neoadjuvant treatment is administered because of a clinical statement of stage or involvement, code EOD based on this clinical information, even if later pathologic information would lead to a lesser EOD. General guideline number 6 (page 1 of SEER EOD-88 3rd ed.) points out that clinical information must be considered when coding EOD. However, do not code EOD based on clinical information disproved by pathologic findings in the absence of intervening treatment. The scenario above: The clinical involvement of the nodes justifies the neoadjuvant chemotherapy. Therefore, code EOD based on the clinical lymph node involvement.

 2003