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Report Produced: 02/12/2026 03:04 AM

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
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
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
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
20021072 EOD-Size of Primary Tumor--Breast: The path report provides a size for both the Paget disease and the underlying intraductal component in the breast. Should we assume the Paget disease to be invasive and code the size of the primary tumor to that invasive component? See discussion. For example, path diagnosis for resection gave the size of the Paget disease as 1 mm and the size of the underlying intraductal tumor as 4 cm. Should size for this breast case be coded to 040 or 003, less than 3 mm.

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 040 [4 cm], the size of the larger underlying intraductal tumor. Paget disease is classified according to the size of the underlying in situ or invasive tumor. Paget with an underlying in situ tumor is staged as in situ to match the AJCC classification of this disease process.

 2002
20021129 Histology/Date of Diagnosis--Hematopoietic, NOS: What code is used to represent histology for a June 2001 diagnosis of "myelodysplastic syndrome" followed by a September 2001 bone marrow biopsy diagnosis of "myelodysplasia evolving into an acute leukemic state"?

For cases diagnosed prior to 1/1/2010:

Code the Histology field to 9989/3 [myelodysplastic syndrome] and the Date of Diagnosis field to June 2001.

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
20021003 Multiple Primaries (Pre-2007): Whenever two hollow organs are diagnosed simultaneously with the same histology, one being invasive and the other in situ, can one assume that mucosal spread has occurred and that this situation represents one primary? In the absence of a physician statement, how do you determine mucosal spread from one organ to another?

For tumors diagnosed prior to 2007:

Yes, this type of situation represents one primary. A tumor that is breaking down can be invasive in the center with in situ cancer at the margins. Occasionally the in situ margin can move into a contiguous organ with the same type of epithelium.

Physicians may describe mucosal spread in various manners. You will see the terms "intramucosal extension," "in situ component extending to," or statements of an invasive component in one organ, with adjacent/associated in situ carcinoma in a contiguous organ with the same type of epithelium. A frequent example of this process is bladder cancer extending into the prostatic urethra via mucosal spread.

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
20021036 EOD-Extension--Urinary Tract: Can the rules used to code bladder extension involving the term "no involvement of muscularis/and no mention of subepithelium/submuscosa" be used to code extension for other urinary tract primaries, such as ureter?

For cases diagnosed 1998-2003:

No. The inferred descriptions of noninvasion apply to bladder cases only.

 2002
20021045 Histology/Grade, Differentiation--Lymphoma: What code is used to represent the histology "high grade malignant lymphoma with features of so called blastic NK cell cutaneous lymphoma [hematodermic lymphoma]" found on punch biopsy?

For cases diagnosed prior to 1/1/2010:Code the Histology field to 9709/3 [cutaneous lymphoma, NOS]. Code the Grade, Differentiation field to 8 [NK 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.

 2002
20021199

Primary Site/Surgery of Primary Site--Lymphoma: What codes are used in these fields when both regional lymph nodes and an extra-nodal site are involved with lymphoma and there is not a clear statement from the clinician as to the primary site? See discussion.

In our registry, we code the primary site for such cases to the extra-lymphatic site if there is one extra-nodal site involved with disease and the patient does not have disseminated involvement of multiple extra-nodal sites. Is this correct? Example: A patient with a submandibular lymphoma and involved nodes undergoes a salivary gland excision and a modified radical neck dissection yielding 100 nodes.

For cases diagnosed prior to 1/1/2010:Code the Primary Site to C08.0 [submandibular gland] and use the surgery code schemes that apply to that site (Parotid and Other Unspecified Glands). Physiologically, lymphoma cells in regional lymph nodes do not "back-flow" into the extralymphatic organ to involve it secondarily. As a result, the primary site is usually the extralymphatic organ with regional lymph node involvement. Do not be afraid to code an extralymphatic site as primary when that site and its regional nodes are involved.

If the lymph nodes are not regional to the extra-nodal involved site and the primary site cannot be determined, code the primary site to C77.9 [Lymph node, NOS].

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