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Report Produced: 03/01/2026 13:09 PM

Report Question ID Question Discussion Answer Year
20021171 Date Therapy Initiated: How would you estimate the date treatment began for a patient who was treated elsewhere and seen only on an outpatient basis at the current facility? See discussion.

July 19th: Retromolar trigone primary was diagnosed.

August 8th note states, "Pt is not a surgical candidate due to multiple medical co-morbidities." Sept 19th note states, "Per Tumor Board, pt has been undergoing radiation for her head and neck cancer." The exact starting date for radiation is not specified.

In the SEER Program Code Manual it states that "In the absence of an exact date of treatment, the date of admission for that hospitalization during which the first cancer directed therapy was begun is an acceptable entry."

If possible, review the radiation treatment summary and outpatient records at the treating facility. If the date treatment began is not stated, look for the completion date and number of treatments, and calculate the first date of treatment.

If the date radiation started cannot be found or calculated, code the month as 09 for the example provided. The determination was made in August NOT to treat with surgery. We know that there was treatment in September.

 2002
20021066 Histology: How do we code this field when a less representative specimen has a more specific morphology? See discussion. Example: Biopsy revealed endometrioid adenocarcinoma and the resection demonstrated adenocarcinoma, NOS. Do we code histology per the most representative sample, or to the more specific morphology?

Code the histology using the pathology report from the most representative specimen, even if that histology is less specific.

For the case example above, code 8140 [adenocarcinoma, NOS].

The rationale is that a diagnosis from a smaller specimen will be less accurate and less representative of the true histology compared to a larger tumor specimen.

 2002
20021185 Surgery of Primary Site--Major salivary gland: How do you code Surgery of Primary Site for a submandibular gland primary when the operative report refers only to an excision of the submandibular "tumor" while the pathology report states the submandibular "gland" was removed? See discussion. The gross description on the pathology report indicates that the specimen consists of a "submandibular gland." A further description on the pathology report included, "the specimen was sectioned exposing a focally cystic mass that nearly replaces the entire specimen." For cases diagnosed on 1/1/2003 or after: Code the Surgery of Primary Site field to 40 [Total parotidectomy, NOS; total removal of major salivary gland, NOS], per the pathology report's gross description of the specimen unless the operative report description of procedure indicates that the removal was less than total. 2002
20021079 Primary Site/Histology (Pre-2007)/EOD Fields/Surgery of Primary Site--Abdomen, NOS: What codes are used to represent these fields for a case with a resection of the rectosigmoid and adjacent tumor mass that demonstrated no tumor in the rectosigmoid but extramural to the colon there was an endometrioid adenocarcinoma arising in association with an area of endometriosis (possibly within the pericolic soft tissue or in an ovarian remnant)?

For cases diagnosed in 2003, code to:

Primary Site: C76.2 [abdomen, NOS]

Histology: 8380/3 [Endometrioid adenocarcinoma]

EOD size, extension, lymph node: 999, 99, 9 [Unknown]

Surgery of Primary Site: 98 [All unknown and ill-defined disease sites, WITH or WITHOUT surgical treatment]

Scope of Regional LN Surgery: 0 [None]

Surgical Procedure of Other Site: 2 [Non-primary surgical procedure to other regional sites].

 2002
20021111 Histology/Grade, Differentiation--Lymphoma/Leukemia: Do you agree with coding a diagnosis of Nasal NK/T cell lymphoma to 9719/38?

For cases diagnosed prior to 1/1/2010:Yes. Code the Grade, Differentiation field to 8 [NK cell] rather than 5 [T-cell]. Code the Histologic Type to 9719/38 [NK/T-cell lymphoma, nasal and nasal-type with Cell indicator of NK (8)].

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.

 2002
20020054

Multiple Primaries (Pre-2007)--Ovary: Are mucinous cystic tumors of low malignant potential diagnosed in the left ovary in 12/2000 and in the right ovary in 7/2001 reportable as two primaries? See discussion.

Page 14 of the SEER Program Code Manual, 3rd Edition, states that bilateral retinoblastomas and bilateral Wilms tumor are always single primaries whether simultaneous or not. Does this apply to bilateral ovarian tumors as well?

For cases diagnosed 2001-2006:

Borderline tumors are not reportable to SEER as of 2001. If you are collecting them in your registry, use the following procedure: Exception 1 in the SEER Program Code Manual, 3rd Edition, responds to the issue of processing ovarian tumors. Simultaneously occurring ovarian tumors with a single histology are coded as one primary. In the case you cite, the right ovary primary occurred 7 months after the left ovary primary. This is not simultaneous, so it would be counted as a second 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.

 2002
20021074 Tumor Markers--Breast: If the ERA/PRA results reported differ for separate breast specimens removed for a single primary, do we code the results as positive or negative?

For cases diagnosed 1998-2003:

Code both the Tumor Marker 1 and Tumor Marker 2 fields to 1 [positive] when a single primary breast tumor has both positive and negative ERA/PRA receptors.

 2002
20021204 EOD-Size of Primary Tumor--Cervix: When both a depth and diameter of the tumor are provided and the description of the diameter is provided in a range, how do you code the size of the primary tumor? See discussion.

Path states "microscopic focus of endocervical glands considered invasive adenoca...maximum depth of that focus measures approximately 2 mm. Maximum diameter of that focus measures 3-4 mm."

What size would be coded for this case: 999, 002, 003, or 004?

Code the EOD-Size of Primary Tumor field to 004 [4 mm]. Code the diameter dimension in the EOD-Size of Primary Tumor field and the depth dimension iin the EOD-Extension field. Code the largest number associated if a range is provided for the diameter of the invasive tumor.

If the size of the diameter had not been mentioned, the EOD-Size of Primary Tumor field would have been coded to 001 [microscopic focus or foci only], which ignores the size associated with the depth dimension of the tumor.

 2002
20021194

Grade/Histology (Pre-2007)--All Sites: What code is used to represent these fields for the histology "High grade dysplasia (adenocarcinoma in situ)" or "AIN III/High grade AIN"?

For tumors diagnosed prior to 2007:

Code the Histology field for the first example to 8140/2 [Adenocarcinoma, NOS, in situ] and for the second example to 8077/2 [AIN, grade III]. For both of the cases code the Grade, Differentiation field to 9 [Cell type not determined not stated or not applicable]. The 6th digit (grade code) of ICD-O-3 describes how much or how little a malignant tumor resembles the normal tissue from which it arose. In contrast, "grade" is used in the examples above to describe the degree of dysplasia, from mild dysplasia (low grade) to severe dysplasia (high grade). Do not record the degree of dysplasia in the 6th digit grade field.

For tumors diagnosed 2007 or later, refer to the MP/H rules for histology coding instructions. 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
20021055 EOD-Extension--Liver: Can we use CT scan descriptions such as "portal vein thrombosis" or "extensive infiltration of the liver" or "diffuse infiltration of the liver" to code extension for liver primaries? See discussion.

1. Would you code portal vein involvement for a CT scan description of "portal vein thrombosis"?

2. Would you code more than one lobe of the liver as involved for CT scan descriptions of "extensive infiltration of the liver" or "diffuse infiltration of the liver"?

For cases diagnosed 1998-2003:

1. No. Thrombosis can be caused by non-cancerous conditions.

2. Yes. Code the EOD-Extension field to 65 [Multiple (satellite) nodules in more than one lobe of the liver] when "extensive infiltration" or "diffuse infiltration" is stated.

 2002