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Report Produced: 02/26/2026 16:29 PM

Report Question ID Question Discussion Answer Year
20010099 EOD-Extension--Pancreas: How do you code extension when CT scan shows a mass in the head of the pancreas "encompassing" the hepatic branch of the celiac artery? See discussion. We do not code the term "encompasses" as involvement. However, should we code this case as extension to the peripancreatic tissue, NOS or as unknown?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 40 [Extension to peripancreatic tissue, NOS]. There has to be extension to peripancreatic tissue if the mass encompasses the celiac artery.

 2001
20010161 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Prostate: Radical prostatectomy reveals two distinct tumors. One is "adenocarcinoma with ductal differentiation" and the other is "adenocarcinoma with acinar differentiation." What code is used to represent the histology and how many primaries does the patient have?

For tumors diagnosed 2001-2006:

This is one primary. Code the Histology field to 8255/3 [adenocarcinoma with mixed subtypes] based on rule A of the Coding Complex Morphologic Diagnoses. This is code was added in the ICD-O-3.

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.

 2001
20010143 EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Lung: How do you code these fields for clinically positive lymph nodes when the result of neoadjuvant treatment is that the lymph nodes are pathologically negative? See discussion.

The pt presents with "mediastinal adenopathy" for a lung primary and was treated with pre-operative radiation therapy. After two months, he was treated with surgery. The 10 lymph nodes removed were all negative. How does SEER code these three EOD fields?

Will an error be triggered in SEER Edits if you code lymph nodes as clinically positive in the EOD lymph node involvement field and yet pathologically negative in the number of regional nodes positive and number of regional nodes examined fields?

For cases diagnosed 1998-2003:

Code the EOD-Lymph Nodes field to 2 [Mediastinal, NOS]. Code the EOD-Regional Lymph Nodes Positive and Examined fields to 00/10. You will not have a problem with the SEER Edits. The EOD field is coded using clinical and pathologic information. All information gathered within four months of the date of diagnosis (in the absence of disease progression) or through completion of surgery(ies) can be used to code EOD. The clinically positive nodes justify the radiation therapy.

 2001
20010118 All Surgical Fields/Radiation Sequence with Surgery--Unknown Primaries: What codes are used to represent these fields for an unknown primary treated with a radical neck dissection followed by radiation therapy?

For unknown primaries treated with a lymph node dissection and diagnosed 1/1/2003 and after, code:

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

2) Scope of Regional Lymph Node Surgery: 9 [Unknown or not applicable].

3) Surgical Procedure of Other Site: 1 [Surgery to other site(s) or node(s), NOS; unknown if regional or distant].

4) Radiation Sequence with Surgery: 3 [Radiation after surgery]. Any planned surgical treatment is used to code radiation/surgery sequence (per CoC I&R).

 2001
20010096

Multiple Primaries (Pre-2007)--Bladder: Should an invasive malignancy following an in situ malignancy by more than two months be a new primary? Why? See discussion.

Example: An in situ bladder case was diagnosed and treated. Three months later another TURB diagnosed an invasive bladder carcinoma. Is the invasive case reportable to SEER as a new primary?

For tumors diagnosed prior to 2007:

Yes. These are two primaries.

In situ cancers are not included in SEER incidence rates. Incidence rates must correlate with mortality rates.

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.

 2001
20010104 Date of Diagnosis--Lung: Based on Note 7 in the lung EOD, should the Date of Diagnosis field be coded to an earlier CT scan date with a reported diagnosis of "RUL mass with mediastinal lymphadenopathy" or to the later biopsy date with a reported diagnosis of small cell carcinoma? See discussion. Note 7 states that "mediastinal lymphadenopathy" indicates involved lymph nodes for lung primaries. Should the date of diagnosis be back-dated to the date of the scan?

For cases diagnosed 1998-2003:

No, code the Date of Diagnosis field to the later biopsy date. Note 7 is intended for use in coding the EOD-Extension field, not the Date of Diagnosis field. The earlier scan has a diagnosis of RUL "mass" not a "malignancy" so the fact that there is mediastinal lymphadenopathy mentioned in that scan is not used to help determine date of diagnosis.

 2001
20010145 EOD-Extension: There is a one to many relationship between T values in TNM staging and SEER EOD-Extension values (one T value can be coded to many extension values). For most situations, we can typically code EOD-Extension to the lowest value in the range available for that T value per the SEER guidelines. But, what happens if another tumor feature, such as tumor size, was involved in the assignment of a T value? See discussion. Example: Physician stages lung tumor as T2. The lowest extension code, 20, doesn't precisely fit the guidelines for a T2 tumor because the T2 stage may be based on the size of the tumor, which doesn't have anything to do with the EOD-Extension field. Should EOD-Extension be coded to 30 rather than 20?

The criteria for AJCC stage T2 consists of both size and tumor extension values. Size of tumor is recorded in the EOD-Size of Primary Tumor field. If you determine that size is the physician's sole criteria for assigning a T2 value, code an EOD-Extension value that reflects more specific information than 30 [localized, NOS]. Code to 10 or 25, depending on the case.

If the tumor size is not provided, and there is only a clinician statement that describes the lung tumor as a stage T2, code EOD-Extension to 20, the numerically lowest equivalent EOD-Extension code for the lung T2 category.

 2001
20010007 Surgery of Primary Site--Skin: For skin primaries diagnosed 1998-2002, what is the difference between code 40 [Wide excision or re-excision of lesion or minor (local) amputation, NOS] and 50 [Radical excision of a lesion, NOS]? Codes 40 and 50 are not in the scheme for 2003 forward. See history for coding cases diagnosed 1998-2002. 2001
20010156 Multiple Primaries (Pre-2007)--Breast: Patient diagnosed with two lumps in same breast, different quadrants at same time. One was ductal carcinoma, cribriform type; the other was ductal carcinoma. How many primaries do we code? See discussion. If the breast cancer had been diagnosed in 2000 we would have coded this case as one primary, code to higher ductal ca. For a 2001 or later diagnosis, should this be coded as two primaries?

For cases diagnosed 1998-2003:

Code this case as two primaries if the tumors are separate. Separate tumors have clear (negative) margins. If the tumors are not separate, code as one 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.

 2001
20010155

Reportability/Diagnostic Confirmation--Melanoma: Would a shave biopsy diagnosis of "highly suggestive of early melanoma", followed by a re-excision diagnosis of "no residual disease", be SEER reportable if the clinician referred to the case clinically as a melanoma? If so, what would the Diagnostic Confirmation be? See discussion.

Pathology report from a shave biopsy states: "...markedly atypical junctional melanocytic proliferation. Changes highly suggestive of early melanoma arising adjacent to superficial congenital nevus." The re-excision pathology report states "biopsy proven melanoma" in the "Clinical History" section of the report (which is a reference to the original shave biopsy). The re-excision final pathology diagnosis states "no evidence of melanoma." The physician states that he thinks this is a melanoma. Should it be reported? Should Diagnostic Confirmation be coded to 1 or 8?

The case is reportable because the physician documented a clinical diagnosis of malignant melanoma. Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only (other than 5, 6 or 7)].

 2001