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Report Produced: 10/29/2025 04:41 AM

Report Question ID Question Discussion Answer Year
20000486 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined/Surgical Procedure of Other Site--Kaposi Sarcoma: How do you code these fields for a groin mass excision containing 4 lymph nodes for a Kaposi sarcoma case that presented with multiple skin lesions?

Code the EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined fields to 99 99 for Kaposi cases that present systemically and for those that present in more than one site (which includes cases with more than one skin subsite involved at diagnosis). There are no "regional" lymph nodes for such cases. This represents a majority of currently diagnosed Kaposi cases. However, for localized Kaposi cases, you can count the number of regional lymph nodes positive and examined if the primary site selected has a regional lymph node chain(s) associated with it (e.g., soft palate, hard palate, or a skin subsite).

For cases diagnosed 1/1/2003 and after: Code the groin mass excision in the Surgical Procedure of Other Site field to 1 [Non-primary surgical procedure performed; Non-primary surgical resection to other site(s), unknown if whether the site(s) is regional or distant].

 2000
20000429 EOD-Size of Primary Tumor--Breast: For breast cancer cases, is code 002 [Mammography/xerography diagnosis only with no size given (tumor not clinically palpable)] to be used only when there is no work-up beyond a clinical one? See discussion.

Usually when a mammogram has a malignant diagnosis, the tumor is clinically palpable, but occasionally the tumor is not palpable.

For example, on the mammogram, lesions are identified in the breast. PE--the breasts are palpably normal. Breast biopsies--two ductal carcinomas, no statement of size. Mastectomy--no residual. Should the size be coded to 999 rather than 002?

For cases diagnosed 1998-2003:

In the case you provided, code the EOD-Size of Primary Tumor field to 002 [Mammography/xerography diagnosis only with no size given (tumor not clinically palpable)]. A known code in the size field should always take precedence over 999 [Not stated]. Code size from the records in priority order as stated in EOD, from pathology, op report, PE, mammogram, etc. (See EOD for complete instructions.)

Code size as 999 only when there is a clinically palpable lesion with no size stated in the path, PE, or mammogram.

If there is a lesion seen on mammogram that is not clinically palpable, a stated size taken from the path or mammogram would take precedence over code 002; however, if there is no stated size, use code 002 rather than 999.

 2000
20000509 EOD-Extension--Small Intestine: How do we interpret a pathology description of "extending through serosa and forming masses in the periserosal tissue" for a jejunum primary?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 55 [Invasion of/through serosa and adjacent connective tissue]. The description states the tumor extended through the serosa into periserosal tissue. The periserosal tissue in this case refers to adjacent connective tissue lying exterior to the intestinal wall and not the (sub)serosal tissue that lies exterior to the muscularis but inferior to the serosa. Analyze each case individually since pathologists are not consistent when using the above terminology.

 2000
20000428 EOD-Clinical Extension--Prostate: How do you distinguish between clinical extension codes of 10, 13, 14, and 20 for cases with a benign prostate per digital rectal exam that appear localized after TURP/prostatectomy? Can the clinical extension code of 10 be used if the term "microscopic carcinoma" is noted in the pathology report without also mentioning "foci" or "Stage A" for clinically inapparent tumors?

For cases diagnosed 1998-2003:

When the prostate feels benign and the cancer is found incidentally at the time of the microscopic exam, code the EOD-Extension field to 10 [number of foci or % of involved tissue not specified]. Code as 13 (less than or equal to 5%) or 14 (greater than 5%) if percentage involved is given in the tissue resected. If the path report states "solitary focus of carcinoma" without mentioning the total amount of tissue resected, code extension to 13. If there is more than one focus, code extension to 10. Don't assign a code of 20 unless the tumor is clinically apparent.

 2000
20000556 Surgery of Primary Site--Cervix: How is this field coded for a cervix primary when a biopsy removes the entire tumor? See discussion. Path from biopsy shows "severe dysplasia--CIN III" and the report from an endocervical curettage (ECC) is "chronic cervicitis"? For cases diagnosed 1998 and later: Code the Surgery of Primary Site field to 25 [Dilatation and curettage; endocervical curettage (for in situ only)]. 2000
20000552 EOD-Size of Primary Tumor--Breast: If the patient has inflammatory carcinoma of the breast, is the tumor size coded as 998 even though we have a tumor size?

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary tumor field to 998 [Diffuse; widespread; 3/4 or more of breast; inflammatory carcinoma] for all inflammatory breast carcinomas.

These cases have a worse prognosis because of the dermal lymphatic invasion. Half of the inflammatory breast carcinomas will have no palpable mass.

 2000
20000516 Diagnostic Confirmation--Prostate: How do we code this field when there is an elevated PSA, no other work-up and there is a clinical diagnosis of adenocarcinoma? Code the Diagnostic Confirmation field to 5 [positive laboratory test/marker study] to indicate the diagnosis is based upon an abnormal PSA tumor marker if the physician uses the PSA as a basis for diagnosing prostate cancer. 2000
20000513 Multiple Primaries/Histology (Pre-2007)--Bladder: What code is used to represent the histology and how many primaries should be coded for a TURB specimen that demonstrates carcinoma in situ, Grade I to II papillary transitional cell carcinoma, and high grade transitional cell carcinoma? See discussion.

Pathology report:

A. Biopsy, bladder neck, @ 6:00: Carcinoma in situ

B. Biopsy, Bladder wall, lateral, left:

1. Papillary carcinoma (Grade I-II)

2. Loose fragments of high-grade transitional carcinoma

C. Biopsy, Bladder neck @ 5:00: Carcinoma in situ

D. Biopsy, Bladder neck @ 7:00: Cystitis Glandularis

E. Biospsy, Bladder wall, posterior: Papillary carcinoma (Grade I)

For tumors diagnosed prior to 2007:

Code this case as one primary and code the Histology and Grade, Differentiation fields to 8130/34 [papillary transitional cell carcinoma, high grade].

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.

 2000
20000515

Multiple Primaries (Pre-2007)--Ovary/Endometrium: Is endometrioid adenocarcinoma occuring simultaneously in the left ovary and the endometrium one primary or two? See discussion.

Pathology Final Diagnosis:

Left Ovary: Moderately differentiated endometrioid adenocarcinoma squamous differentiation grade 2 (scale of 3)

Uterus: Moderately differentiated endometrioid adenocarcinoma with squamous differentiation, grade II (scale of III). Focal, very superficial invasion to inner third myometrium with extension to lower uterine segment. Endocervix, cervix, right ovary and fallopian tubes negative for tumor.

For tumors diagnosed prior to 2007:

Code the case you describe as two primaries. The endometrioid adenocarcinoma can arise in the endometrium without a concomitant ovarian carcinoma.

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.

 2000
20000533

EOD-Clinical Extension--Prostate: In the SEER EOD manual, there is a list of terms to distinguish apparent from inapparent tumor for prostate primaries. Are terms in the "maybe" category and are terms not on the list clinically inapparent or clinically apparent when there is no physician staging of the case? See discussion.

The rectal examination states that there is "asymmetrical enlargement of the prostate, firmness over the right lobe" and the physical exam impression is extensive carcinoma of right lobe. A needle biopsy of the right lobe was positive. "Enlarged" is on SEER's list of clinically inapparent terms; "asymmetrical" and "firm, NOS" are on the "maybe" list.

For cases diagnosed 1998-2003:

On the basis of the physical exam impression, code the EOD-Clinical Extension field to 20 [involvement of one lobe, NOS] for this case. Although the medical record did not provide a physician's staging of the case as clinically apparent, the physician did suspect carcinoma prior to the biopsy.

If clarifying stage information is missing and the term is in the "maybe" category or the term is not on the list, then code extension as 30 [localized, NOS] for cases that appear localized.

 2000