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Report Produced: 07/09/2025 06:00 AM

Report Question ID Question Discussion Answer Year
20021183 Primary Site--Head & Neck: What site code is used to represent the following head and neck primary where there is not a clear statement of primary site? See discussion.

6/29/02: PE: 2-3 cm mass in the posterior pharynx that seems to arise from the right side of back of tongue.

6/29/02 CT soft tissue of neck: 3 cm right sided oropharyngeal mass, possibly arising from right tongue mass. There is near occlusion of airway at this level.

7/3/02 Excision of oropharyngeal tumor: Palpated mass could clearly be felt coming off the right lateral tongue in approximately the mid portion of the tongue near the tonsillar base.

 Code the Primary Site field to C02.9 [tongue, NOS], based on the information provided. 2002
20021059 Surgery of Primary Site--Soft Tissue: What code is used to represent this field when an excisional biopsy of a soft tissue sarcoma is followed two weeks later with a wide excision (re-excision)? For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 26 [partial resection]. According to the CoC, "Excision" in the surgery codes refers to the lesion and "partial resection" refers to the organ. The biopsy is a local excision (code 25). The wide resection is code 26, presuming that more than just the remaining lesion was removed. 2002
20021041 First Course of Cancer-Directed Therapy--All Sites: How do we code retinoic acid?

The code for retinoic acid depends upon the primary site and histology of the tumor. Code retinoic acid (also called Vitamin A, tretinoin, ATRA, all-transretinoic acid or Vesanoid) in the Immunotherapy field as 01 [Immuno administered as first course therapy] for acute promyelocytic leukemia. This drug is given to patients as an alternative to chemotherapy.

For all other sites/histologies, code retinoic acid in the Other Cancer-Directed Therapy Field. Use code 2 [Other experimental cancer-directed therapy] or 3 [Double-blind clinical trial, code not yet broken] if the drug is given as part of a protocol. If the drug is not being given as part of a protocol or you don't know whether it is part of a protocol, use code 1 [Other cancer-directed therapy].

 2002
20021052

EOD-Extension--Pancreas: Should these terms be ignored when coding extension to 10 or 30, or do they indicate involvement for non-surgically treated pancreas primaries?

1) Stricture of the common bile duct

2) Common bile duct is narrowed

3) Common bile duct is obstructed

4) Common bile duct dilation

5) Malignant stricture of the common bile duct

6) Ampullary or common bile duct stricture with a negative biopsy or brush.

For cases diagnosed 1998-2003:

Ignore these terms when coding extension to 10 or 30. These terms do not verify involvement by pancreatic cancer of the organs mentioned. Other non-malignant circumstances could cause these conditions.

 2002
20021149 EOD-Extension--Head & Neck: In the absence of a clear surgical or pathologic description of how the salivary gland involvement relates to the head and neck primary, do we code the involvement as direct extension, further extension or metastasis? See discussion. A composite resection of tonsillar mass and a modified radical neck dissection is performed. According to the pathology report: Squamous cell carcinoma involvement of tonsil with invasion of skeletal muscle. A separate specimen labeled "tumor" indicates a salivary gland is also involved with tumor. Neck dissection: 1 lymph node with metastasis.

For cases diagnosed 1998-2003:

In the absence of a clear statement that the gland was involved by direct extension, code the EOD-Extension field to 85 [Metastasis]. In this case, the salivary gland tumor was described as a "separate specimen" that contained the salivary gland. The extension does not appear to be contiguous for this case.

If the salivary gland involvement had been by direct extension, which would be assumed if there had been contiguous involvement of the gland with the primary site, then code the EOD-Extension field to 80 [Further extension]. If there had been direct extension, the surgeon probably would not have dissected through the tumor. The resection specimens would have been contiguous.

 2002
20020009 EOD-Extension--Lymphoma: What code is used to represent this field for a lymphoma that involves the spleen and lymph nodes above the diaphragm (e.g., involvement of only the spleen below the diaphragm and cervical lymph nodes above the diaphragm)?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 32 [30 + involvement of the spleen; III S]. The spleen is counted twice (once as the spleen and a second time as a lymph node region below the diaphragm). As a result, the EOD-Extension field is coded to reflect involvement of lymph node regions on both sides of the diaphragm plus involvement of the spleen. See Note 1 on the EOD scheme that states "Any lymphatic structure is to be coded the same as a lymph node region."

 2002
20021205 EOD-Extension--Melanoma: Is "erosion" synonymous with "ulceration" for melanoma cases?

For cases diagnosed 1998-2003:

No, do not interpret the term "erosion" as a synonym for "ulceration" when coding the EOD-Extension field for melanoma. According to AJCC's melanoma curator, erosion is not necessarily the same as ulceration.

 2002
20020024 Reportability--Cervix: The SEER Program Code Manual lists CIN III and carcinoma in situ of the cervix as not being reportable for cases diagnosed in 1996 or later, but does not list "adenocarcinoma in situ" or "squamous cell carcinoma in situ." Are these histologies still reportable?

For primary site cervix uteri, only histologies with behavior codes of 3 [invasive] are reportable to SEER for all registries.

Some SEER registries have opted to continue to collect behavior codes of 2 [in situ] for cervix uteri primaries.

 2002
20021210 Date of Diagnosis/Histology (Pre-2007)--Breast: When there is a delay between the clinical diagnosis of a malignancy and the surgical resection of the primary site, can the resection be used to code the date of diagnosis, extension, size of the primary tumor, and histology? See discussion.

For example, mammogram March 28th states "certainly represents malignancy." Nothing else done until November 1st when pt presents w/skin retraction on PE and bone mets. A mastectomy November 6th shows "ductal ca w/dermal lymphatic invasion and tumor measuring 3.5 cm."

How is the date of diagnosis, extension, tumor size & histology coded for this case?

For tumors diagnosed prior to 2007:

Code the Date of Diagnosis to March. Code the Histology field to 8500/3 [Infiltrating duct carcinoma]. Histology can be upgraded from a clinical histology to a pathological histology anytime.

For cases diagnosed 1998-2003, in coding extension, you need to assess whether there has been progression of disease or not. If progression of disease is verified, do not code extension using the surgical information from November. Code the extension and tumor size based on the mammogram and physical examination at the time of the mammogram, if available.

If no progression of disease is verified, use surgical information to code extension and tumor size.

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.

 2002
20021094 EOD-Extension/EOD-Lymph Nodes--Testis: If the patient received chemo, should "bulky retroperitoneal adenopathy" be coded as involved lymph nodes in the EOD lymph node involvement field for a testicular primary treated with an orchiectomy that rendered a path diagnosis of "seminoma confined to the testicle"? See discussion. Per an orchiectomy path diagnosis a seminoma was confined to the testicle. The only other workup, other than a scrotal ultrasound, was a staging CT scan that revealed bulky retroperitoneal adenopathy in abdomen and pelvis, as well as mediastinal adenopathy. There was also a peripheral pulmonary nodule. No final clinical diagnosis or stage was provided in the chart. Following the orchiectomy the patient was treated with chemo. Should we also have coded distant site lung involvement?

For cases diagnosed 1998-2003, code the EOD-Lymph Nodes field to 9 [unknown] because "adenopathy" is not used to code lymph node involvement. The physician varied from the usual treatment for a localized testicular carcinoma, which is an orchiectomy. The physician proceeded immediately to chemotherapy as further treatment. It is not clear whether the decision to treat with chemo was based on the nodes and/or lung being involved.

Search the record for the physician's opinion regarding distant metastasis. Do not code distant involvement based on a peripheral pulmonary nodule seen on CT without further proof. If no further information is available, code the EOD-Extension field to 99.

 2002