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| Report | Question ID | Question | Discussion | Answer | Year |
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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 | |
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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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20021026 | Surgery of Primary Site--Skin: Should Mohs surgery be code to 27 [Excisional biopsy] or 31 [Shave biopsy followed by a gross excision of the lesion]? See discussion. | Under surgery coding in the 5/22/01 SEER Abstractor/Coder Workshop book, page 20, it states that Mohs surgery should be coded as an excisional biopsy. The ACoS I&R dated 6/6/2001 states that it should be coded to 31. | For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 34 [Mohs surgery, NOS], 35 [Mohs with 1-cm margin or less] or 36 [Mohs with more than 1-cm margin]. | 2002 |
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20021154 | Primary Site: What code is used to represent the primary site for a "teratocarcinoma with features of embryonal carcinoma" removed from the thigh muscle in a patient with x-ray negative testicles? See discussion. |
The case was reviewed by AFIP and called "extratesticular." Per our pathology consultant, the site should be coded to unknown because it is very doubtful that the tumor was primary in the soft tissue of the thigh. According to him, such tumors don't originate exclusively in the testes, but tend to occur along the central axis such as the mediastinum or retroperitoneum. If an extratesticular tumor arises in either of these areas, the primary site should be code to the mediastinum or the peritoneum rather than to unknown. Lesions primary in the testicle may also undergo maturation with fibrosis and involution. This process often leaves little evidence of the original tumor in the testis. |
Code the Primary Site field to C809 [unknown] for this case. The thigh tumor is a metastatic site. |
2002 |
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20021091 | Reportability--Hematopoietic, NOS: Are the terms "thrombocytosis, NOS" and "thrombocythemia, NOS" non-reportable to SEER? See discussion. |
Our understanding from SEER about how to classify these types of clinical impressions for the 2001 and later reportable blood diseases is as follows: If we cannot prove that it is malignant, then we should be conservative and exclude the case for reporting to SEER. |
For cases diagnosed prior to 1/1/2010:The terms "thrombocytosis, NOS" and "thrombocythemia, NOS" are not reportable to SEER. 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 |
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20021201 | EOD-Extension--Lymphoma: What code is used to represent this field for a lymphoma with retroperitoneal lymph node involvement and splenomegaly? | For cases diagnosed 1998-2003:
Per AJCC, code spleen involvement which is demonstrated by:
1. Unequivocal palpable splenomegaly alone. 2. Equivocal palpable splenomegaly with radiologic confirmation (ultrasound or CT). 3. Enlargement or multiple focal defects that are neither cystic nor vascular (radiologic enlargement alone is inadequate).
If the spleen is proven to be involved, code extension for this case as 20 [Involvement of two or more lymph node regions on the same side of the diaphragm; Stage II].
If the spleen is not proven to be involved, code extension as 10 [Involvement of a single lymph node region; Stage I]. |
2002 | |
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20021046 | Behavior Code/EOD-Extension--Bladder: If an in situ lesion of the urinary bladder involves the von Brunn nests, is it still in situ? See discussion. | Von Brunn nests: Compact, rounded aggregates of urothelial (transitional) cells in the lamina propria, with or without connection to the surface epithelium. Urothelial (transitional cell) carcinoma in situ...may involve von Brunn nests... Histologic Typing of Urinary Bladder Tumours, Second Edition, WHO, pp 12 & 21 |
For cases diagnosed 1998-2003:
Code the Behavior Code and the EOD-Extension field according to the pathology report.
If the pathology report states the tumor to be noninvasive or in situ, whether or not von Brunn nests are involved, code behavior as 2 [in situ] and extension as in situ.
If the tumor is described as invasive and involves the von Brunn nests, code the EOD-Extension field to 15 [invasive tumor confined to subepithelial connective tissue] because code 15 includes extension to the lamina propria and von Brunn nests are within the lamina propria. |
2002 |
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20021014 | Reportability: Is "Castleman's Disease" reportable? | For cases diagnosed prior to 1/1/2010:Castleman's Disease is not reportable to SEER. Synonyms for this disease process include: Castleman-Iverson Disease, benign giant lymph node hyperplasia, and angiofollicular mediastinal lymph node hyperplasia. Castleman's Disease is a rare disorder characterized by non-cancerous growths that may develop in the lymph node tissue throughout the body. The plasmacellular form of this disease may progress to lymphoma or plasmacytoma.
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. |
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20021004 | Histology: What code is used to represent the histology for the abbreviation "ca"? See discussion. | The abbreviation "ca" results in inconsistency when coding histology by a group of coders. Many abbreviation guides list both cancer (8000/3) and carcinoma (8010/3) as definitions for "ca." Page 261 of the SEER Self Instructional Manual, Book 5 lists carcinoma as the definition for "ca."
Example: What histology is used for a case with a clinical diagnosis of "recently diagnosed uterine ca" with metastasis to the pelvic lymph nodes? |
For uterine primaries, code the abbreviation "ca" to 8010/3 [carcinoma, NOS].
When coding death certificate only (DCO) cases, if the site is coded to an unknown primary and no specific histology information is available other than the abbreviation "ca," interpret ca as cancer (8000/3) per NAACCR Procedure Guidelines for Registries, Series V; Resolving Death Clearance Issues, page V-15. |
2002 |
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20021015 | Ambiguous Terminology/Reportability: How should the expressions "suspicious for but not diagnostic of" and "suspicious for the possibility of early invasive adenocarcinoma" be interpreted for reportability? Would the interpretation be different depending on the primary site? | For reportability, interpret "suspicious for but not diagnostic of" as NOT diagnostic of cancer.
The phrase "suspicious for the possibility of early invasive adenocarcinoma" may indicate that the case is in situ. If no further information is available, this is not reportable.
The site of the cancer diagnosis does not change the interpretation. |
2002 |
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