Report | Question ID | Question | Discussion | Answer | Year |
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20021142 | Date of Diagnosis: If an originally diagnosed "benign" tumor is later discovered to have "metastasized", should the date of diagnosis be back-dated to the date the original tumor was discovered or to the date the metastatic disease was identified? | Code the Date of Diagnosis field to the date the malignancy is diagnosed. If there was a medical or pathologic review of the original benign diagnosis that indicates that the patient had cancer at the earlier time, then the earlier date is coded as the date of diagnosis. If no medical or pathologic review of the original benign diagnosis is done, then code the date of diagnosis to the date the metastasis is discovered. | 2002 | |
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20021157 | Histology (Pre-2007)/Grade, Differentiation--Lung: What code is used to represent the histology for a lung biopsy of "non-small cell carcinoma with features of poorly differentiated adenocarcinoma"? See discussion. | Non-small cell carcinoma does not appear to be an NOS term in ICD-O-3. The term "with features of" indicates a majority of tumor. Which rule should be used to code histology? | For tumors diagnosed prior to 2007:
Code the Histology and the Grade, Differentiation fields to 8140/33 [adenocarcinoma, poorly differentiated].
The term "non-small cell carcinoma" is used to represent a broad category of epithelial cancers. Non-small cell carcinoma [8046/3] is grouped in the ICD-O-3 under "Epithelial Neoplasms, NOS." The term can be used by a pathologist when he rules out the fact that the patient has a small cell cancer by stating that the malignancy is a non-small cell type of cancer. In this case, the type of non-small cell cancer present in the specimen is adenocarcinoma.
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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20020049 | EOD-Extension--Breast: Should clinically mentioned "thickening" of the breast be ignored if the pathology report does not mention thickening or skin involvement? See discussion. | For cases diagnosed 1998-2003: Can clinical "thickening" of the breast be coded to 20-28 extension code when there is no mention of the thickening or skin involvement in the pathology report? How do we code cases when pathology reports don't support the clinical finding of skin involvement. | For cases diagnosed 1998-2003: Do not use code 20-28 when there is no preoperative treatment and the pathology report does not confirm skin invasion. The clinical diagnosis of skin involvement was not supported by the pathology report. | 2002 |
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20020063 | EOD-Extension--Breast: How do we interpret "dermal lymphovascular space invasion" and "dermal lymphovascular invasion" for extension? See discussion. | A breast path report states tumor invades dermal lymphovascular spaces. Also, pathologists sometimes state "dermal lymphovascular invasion". Are both these terms synonymous with dermal lymphatic invasion? | For cases diagnosed 1998-2003:
Dermal lymphovascular invasion and tumor in dermal lymphatics would both be coded as dermal lymphatic invasion. |
2002 |
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20020053 | EOD-Extension--Meninges: How do you code extension for a malignant meningioma that invades into the adjacent brain tissue? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 60. Code 60 is defined as a brain tumor that extends into the meninges. It is also the appropriate code to use for a tumor that extends from the meninges to the brain. |
2002 | |
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20021144 | EOD-Extension--Colon: What code is used to represent this field for a mid-ascending colon primary that invades through muscularis propria and into subserosal fibroadipose tissue that also presents with a "separate serosal nodule" of carcinoma within cecum that is consistent with a tumor implant (cT3, N0, M1)? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 85 [Metastasis], because the nodule of carcinoma in the cecum is not contiguous with the mid-ascending primary colon tumor. |
2002 | |
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20021105 | Grade, Differentiation: Do we code to the highest grade even when no grade is given at the time of initial diagnosis, but a grade is obtained on tissue removed after non-surgical treatment has occurred? See discussion. | 1. In 2000 a pleural fluid aspirate had no grade. Pt treated with chemo. In 2000 a BSO diagnosed high grade papillary serous adenocarcinoma of the ovary. 2. In 1993 a prostate bx had no grade. Pt treated. In 2001 prostate bx revealed a Gleason's 4+3. |
Code the grade at the time of initial diagnosis (if the specimen is from the primary site) or to the grade identified as part of a first course of cancer-directed surgery to the primary site. When different grades are specified for tissue pathologically reviewed from the primary site before and after treatment, code the higher grade. This is true even if the higher grade is obtained while the pt is still undergoing first course of cancer-directed therapy. 1. Code the Grade to 4 [high grade], if the grade information from the BSO specimen represents the grade associated with primary site surgical specimen. Even though the grade was obtained after first course of cancer-directed therapy started, it was obtained during first course of cancer-directed therapy. 2. Code the Grade to 9 [Cell type not determined, not stated or not applicable]. Grade was obtained well after the first course of cancer-directed therapy ended. |
2002 |
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20021121 | Multiple Primaries (Pre-2007)--Kidney: How many primaries are reportable in a patient treated with a bilateral nephrectomy that revealed multiple tumors within each kidney and the histology in both the left and the right kidney was "renal cell carcinoma, indeterminate type: multiple histologically identical tumors" and the clinical discharge diagnosis was "bilateral renal cell carcinoma, probably surgically cured"? See discussion. | The SEER manual states "If only one histologic type is reported and if both sides of a paired site are involved within two months of diagnosis, a determination must be made as to whether the patient has one or two independent primaries." Frequently, the only statement we have is that "bilateral organs are involved." Additional guidelines for determining number of primaries would be helpful. | For tumors diagnosed prior to 2007:
Report this case as two primaries, left and right kidneys. According to our pathologist consultant, "The description sounds like bilateral multiple primaries. Multicentricity in the same kidney occurs in about 4% of all cases, and bilaterality in 0.5 to 3% (Atlas of Tumor Pathology, Tumors of the Kidney, Bladder, and Related Urinary Structures)."
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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20020059 | Grade, Differentiation: Can a FIGO grade be coded in this field or is the FIGO grading system to be used only for EOD/Stage coding? |
This answer pertains to cases prior to 2014. For cases diagnosed 2014 and forward, see http://seer.cancer.gov/tools/grade/
Do not use FIGO grade to code differentiation.
FIGO grade is something completely different from FIGO stage. FIGO stage is used to code EOD. FIGO grade is based on the percentage of non-squamous (i.e., solid) portions of the tumor and corresponds roughly to a three grade differentiation system: grade I, well differentiated (=<5% solid component); grade II, moderately differentiated (>5 - 50% solid); and grade III, poorly differentiated (> 50% solid). SEER is evaluating whether the ICD-O-3 6th digit differentiation codes (four grade categories) accurately represent the FIGO grade. For the time being, do not code FIGO grade.
For a diagnosis that includes commonly used differentiation term with a FIGO grade, such as "Moderately differentiated, FIGO grade II," disregard the FIGO grade and code the Grade, Differentiation field according to the term "Moderately differentiated." |
2002 | |
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20020069 | Reportability--Hematopoietic, NOS: Is "evolving" multiple myeloma reportable to SEER? | For cases diagnosed prior to 1/1/2010:No, it is not SEER reportable. The diagnosis of "evolving" multiple myeloma could represent a plasmacytoma, plasma cell dyscrasia or another lymphoproliferative disorder. Some of these histologies are SEER reportable, but some are not. Additional information would be needed to determine reportability. If you are unable to obtain more information, the case is non-reportable.
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 |