| Report | Question ID | Question | Discussion | Answer | Year |
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20021089 | Primary Site--Ovary/Peritoneum: When ovaries are not found on a resection or if the ovaries removed are negative for malignancy, but the clinician refers to the adenocarcinoma in the pelvis as being an "ovarian" primary, should the primary site be coded as ovary, pelvic peritoneum or unknown? See discussion. | Example 1: Patient has a history of a BSO without an indication that it was done for malignancy. Pt has a resection. No ovarian tissue found. No site is mentioned in the pathology report. The clinician refers to the diagnosis of adenocarcinoma in the pelvis as an "ovarian" primary.
Example 2: Resected ovaries are negative. No specific site of origin is mentioned in the path. Again, the clinician refers to the diagnosis of adenocarcinoma in the pelvis as an "ovarian" primary. |
Code the Primary Site for both examples to peritoneum [C48.2]. When the physician refers to a case as "ovarian" even though the ovaries are negative or when the histology is an ovarian histology, such as papillary serous ca, the primary site should be coded to the peritoneum. Code the Primary Site to where it appears the disease is arising. | 2002 |
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20020015 | Histology (Pre-2001): For cases diagnosed before 1/1/01, what code is used to represent the histology "small cell neuroendocrine carcinoma"? | For tumors diagnosed prior to 2001, code the Histology field to 8041/3 [small cell carcinoma] for "small cell neuroendocrine carcinoma". | 2002 | |
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20021115 | EOD-Lymph Nodes--Testis: In coding lymph node involvement for a testicular primary, should we use code 5 (Size not stated) when there is not a pathologic size of the lymph node provided? See discussion. | Should Note 1 in the testis EOD be changed to "Metastases in lymph nodes are now measured by the size of the lymph node as stated in pathology report"? The SEER EOD-88, 3rd Edition, states that "when size of regional lymph nodes is required, code from the pathology report." | For cases diagnosed 1998-2003:
For testis cases only, "metastasis in lymph nodes" is measured by the size of the lymph node or the lymph node mass. It is acceptable to code the size of this metastasis from a CT scan or other imaging when a pathology specimen is not available for testicular primaries. |
2002 |
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20021190 | Histology (Pre-2007)--Bladder: What code is used to represent the histology "transitional cell and small cell carcinoma" of the bladder? See discussion. | Code 8045/3 is used for combination codes that represent a mixture of small cell carcinoma and any other carcinoma. When we use this histology code for bladder primaries with mixed transitional cell and small cell carcinoma, we encounter a problem with the SEER edits (site and morphology conflict). | For tumors diagnosed prior to 2007:
Please see SEER Inquiry question ID number 20041104.
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 |
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20021206 | EOD-Extension--Breast: The SEER coding scheme classifies the in situ portion as less than 25% [code 14] or equal to or greater than 25% [code 15]. How do you code a pathologist's statement of "less than or equal to 25%"? See discussion. | "insitu ca constitutes less than or equal to 25% of the total mass." | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 14 [invasive and in situ components present, size of entire tumor coded in Tumor Size AND in situ described as minimal (less than 25%)]. The pathologist did not use a code as defined by SEER. For cases described as "less than or equal to 25%", choose the lower of the two EOD code choices. |
2002 |
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20021056 | Histology (Pre-2007)/Terminology: Are "pattern", "architecture", and "architectural pattern" terms that indicate a majority of tumor? |
For tumors diagnosed 2004 to 2006: The terminology "Architectural pattern: ____________," when used in the final pathology diagnosis, indicates a subtype that can be coded. This type of format in a pathology report is based on a College of American Pathologists (CAP) protocol. Disregard "pattern" and "architecture" when not used in accordance with the CAP protocol. See www.cap.org for cancer protocols. 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 | |
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20021197 | Scope of Regional Lymph Node Surgery--Breast: How should this field be coded when a mastectomy that removed 3 sentinel lymph nodes is later followed by an axillary lymph node dissection that removed 17 lymph nodes? Should all of the lymph node information be coded to this field, even though the Number of Regional Lymph Nodes Examined field will be coded to the number of lymph nodes from the most definitive surgery (17)? | For cases diagnosed 1/1/2003 and after: Yes, all of the lymph node information should be coded to the Scope of Regional Lymph Node Surgery field using code 7 [Sentinel node biopsy and code 3, 4, or 5 at different times].
The Number of Regional Lymph Nodes Examined field no longer exists for this time frame. |
2002 | |
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20021099 | Reportability/Histology (Pre-2007)--Pancreas: Are the following pancreatic tumors with mention of "low grade malignant potential/borderline" reportable to SEER? If so, what histology and behavior codes should be used? See discussion. | 1. AFIP diagnosis: Pancreas, tail, resection: Mucinous cystadenocarcinoma (mucinous cystic neoplasm) of low grade malignant potential. Comment: There are no reliable histomorphologic features which can separate these neoplasms into benign and malignant tumors, and so we consider them all to be low grade malignant tumors.
2. Whipple resection: Intraductal papillary mucinous tumor of the pancreas with extensive low grade and multifocal high grade ductal dysplasia (so-called borderline tumor and carcinoma in-situ). |
For tumors diagnosed prior to 2007:
Both tumors are reportable to SEER.
1. Code the Histology and Behavior Code fields to 8470/3 [Mucinous cystadenocarcinoma, NOS].
2. Code the Histology and Behavior Code fields to 8453/2 [Intraductal papillary-mucinous carcinoma, non-invasive].
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 |
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20021187 | Reportability: When a hospital pathologist sends the slides from an original biopsy to two or more outside reviewers and the reviewers differ on whether or not the case is reportable, is the case SEER reportable? Does the decision to treat the patient have any bearing on whether the case would be reportable? |
Typically, the final diagnosis of the reviewing pathologist is the one used to determine whether the case is SEER reportable. If two or more reviewing pathologists disagree as to whether the case should be reportable, determine reportability based on the following priority order: 1) If the patient is treated for cancer, the case is reportable. 2) If the patient is not treated for cancer, use the amended diagnosis on the original pathology report if the hospital pathologist used the reviewing pathologists' opinions in establishing his new diagnosis. 3) If there is not an amended diagnosis for the original hospital pathology report, use the clinician's opinion regarding what the diagnosis is to determine whether the case is reportable. |
2002 | |
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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 |
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