| Report | Question ID | Question | Discussion | Answer | Year |
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20150020 | Reportability/Primary site--Skin: Is a basal cell carcinoma of the lip "ever" reportable and if so, what would need to be documented or seen? See discussion. |
There is a 1988 case that hit the SEER edits for other reasons but not because of that site/histo combination (C000 and 8090/3); however, there is no text. Per a Dataminer query, there are 42 cases in the state database with C000-C009 and 8090. On review, a few did have a mention of the word "upper lip/mucosa" in the PE text or OP findings (not path because a lot of these are removed in the MD office and we don't see the path report). Other times, there is no mention but the abstractor used the C00 codes instead of C44 so the cases get through. SINQ #20031110 addresses this in relation to C000, Lip, NOS but we want to know if this answer meant you would never report a basal carcinoma lip case period (even if there is a mention of mucosa or any mention of mucosa in the path report). Are there any exceptions? It seems if you would never report a basal lip carcinoma, then SEER would block those cases from being reported/submitted and the wording would be stronger in the SEER manual. Right now the reportability only addresses if someone codes C44 but if someone decides to use C00 codes then it is allowed. Under Primary Site, there is even a listing under 12 for "absence of any additional information" and lists "Colored / lipstick portion of upper lip" as code C000. |
BCC of lip C00_ is rare and requires a statement that the tumor is on the vermilion border (rather than skin) to be coded C00_ and to be reported. Our expert pathologist consultant refers to an article in the Am Acad Dermatol 2004; 50(3): 384-387. |
2015 |
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20150054 | Primary Site--Skin: Should cutaneous leiomyosarcoma be coded to primary skin of site (C44_) or soft tissue (C49_)? |
Code cutanteous leiomyosarcoma to skin. Leiomyosarcoma can originate in the smooth muscle of the dermis. The WHO classification designates this as cutaneous leiomyosarcoma. The major portion of the tumor is in the dermis, although subcutaneous extension is present in some cases. |
2015 | |
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20150039 | Reportability--Skin: Is this reportable? If so, what is the correct histology code? The pathology report says, " bx of 0.7 x 0.5 cm gray-pink papule on tan-pink skin of left inferior centra malar cheek revealed invasive SCC of skin, signet ring cell type, invading papillary dermis; LVI neg; "findings are diag of SCC exhibiting the rare signet ring histologic subtype"; deep margin positive for tumor but peripheral margins clear;". |
SCC of skin, signet ring cell type, is not reportable to SEER. SCC's of skin classifiable to 8050-8084 are not reportable to SEER. See page 11 in the SEER manual, http://seer.cancer.gov/manuals/2015/SPCSM_2015_maindoc.pdf
Signet ring is a rare histological variant of SCC and is coded to 8070/3 according to the WHO classification for skin tumors. |
2015 | |
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20150021 | MP/H Rules/Histology--Skin: How is histology coded for an "endocrine mucin-producing sweat gland carcinoma with transformation to mucinous carcinoma"? See Discussion. |
Endocrine mucin-producing sweat gland carcinoma (EMPSCG) is a rare type of low-grade sweat gland carcinoma. Some journal articles indicate that most patients with EMPSCG have coexisting mucinous carcinomas, suggesting that EMPSCG is a precursor to invasive mucinous carcinoma of the skin. Sweat gland carcinoma has its own histology code per the ICD-O-3 (8400/3); should an endocrine mucin-producing sweat gland carcinoma also be coded as 8400/3? If so, would the correct histology for the skin case above be mucinous carcinoma (8480/3) per Rule H17? Conversely, if the terms "mucin-producing" are referring to mucin-producing carcinoma, and not referring to the sweat gland carcinoma, would the histology be coded 8481/3 (mucin-producing carcinoma)? |
Assign 8480/3.
There is no mixed ICD-O-3 code for EMPSCG. Both histologies are in the mucinous family: mucinous adenocarcinoma (8480/3) and sweat gland carcinoma (8400/3). Apply Other sites rule H17 and code the numerically higher ICD-O-3 code (8480/3).
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare low-grade sweat gland carcinoma with a strong predilection to the eyelid region. It is histologically analogous to endocrine ductal carcinoma/solid papillary carcinoma of the breast and is characterized by a multinodular solid cystic mucinous tumor with immunoreactivity to neuroendocrine markers. Only 20 cases of this unusual tumor have been reported. |
2015 |
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20150047 | Reportability--Bladder: Is a positive UroVysion test alone diagnostic of bladder cancer? See discussion. |
The UroVysion website says that standard procedures, e.g., cytology, cystoscopy, take precedence over the UroVysion test. The Quest Diagnostics website says that "A positive result is consistent with a diagnosis of bladder cancer or bladder cancer recurrence, either in the bladder or in another site within the urinary system. A negative result is suggestive of the absence of bladder cancer but does not rule it out." Would we pick up the case if the UroVysion test was positive but the standard procedures were negative or non-diagnostic? |
Do not report the case based on UroVysion test results alone. Report the case if there is a physician statement of malignancy and/or the patient was treated for cancer. |
2015 |
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20150001 | Reportability/Histology: Would a histology reading "Well-differentiated neuroendocrine neoplasm" of the appendix be reportable? Since the word "tumor NOS" and "neoplasm NOS" both code to 8000, I would assume they would be interchangeable but just wanted to verify. According to SINQ 20130027 & 20140002 a "Well-differentiated neuroendocrine tumor" of the appendix IS reportable. |
"Well-differentiated neuroendocrine neoplasm" of the appendix is reportable. According to the WHO classification of Digestive System Tumors, "Well-differentiated neuroendocrine neoplasm" of the appendix is synonymous with NET. WHO states on page 13 "The term 'neuroendocrine neoplasm' can be used synonymously with 'neuroendocrine tumor.'" Neuroendocrine "tumor," or NET G1, is listed in the WHO classification as one of the malignant neoplasms of the appendix. |
2015 | |
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20150013 | Surgery of Primary Site: What is the most extensive, invasive or definitive surgical procedure when the second surgical procedure performed has a lower surgery code? See discussion.
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Examples
8/xx/13 TURBT with path specimen (27): Papillary Urothelial Carcinoma, HG 9/xx/13 Bladder fulgeration w/o path specimen (12)
5/xx/14 Segmental Mastectomy(24): Ductal carcinoma with <1mm marg 6/xx/14 Breast Re-excision (23): Residual ductal carcinoma 1.5mm, marg neg |
The code in Surgical Procedure of Primary Site should correspond to the most invasive, extensive, or definitive surgery when the patient has multiple surgical procedures of the primary site even if there is no residual tumor found in the pathologic specimen from the more extensive surgery. The timing of the procedures does not affect the code choice.
Assign code 27 for the first example. Assign code 24 for the second example. |
2015 |
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20150060 | Reportability/MP/H Rules: Where can I find documentation on how to accession malignant tumors in transplanted organs? See discussion. |
A patient was diagnosed with hepatocellular cancer (HCC) in 2010, and underwent a hepatectomy, and then received a donor liver. In 2014, HCC was discovered in the liver once again. This likely is a new primary, but there are no specific rules to cover this. There are many odd situations involving transplanted organs, many of which pose reportability and multiple primary problems. |
Accession the new tumor in the transplanted organ as you would any other new/second primary. As transplants have become more common especially for liver, lung, and kidney, we are seeing more of these types of cases. We are adding instructions to the revised MP/H rules on coding subsequent primaries when they occur in a transplanted organ. We are also looking at adding a data field that will identify cancers/tumors which arose in a transplanted organ. We feel this is important to track for analysis. Until the revised MP/H rules are implemented, we will look at adding general coding instructions to the SEER Program Manual for transplants. |
2015 |
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20150058 | MP/H Rules/Multiple Primaries: Is this counted as one or two primaries?
Patient is diagnosed with SCC esophageal cancer. Work-up reveals a lung nodule. Lung FNA (cytology) is read by the pathologist as SCC, favor metastatic esophageal SCC. However, the managing physicians are treating the patient as two separate primaries. |
If the patient is being managed and treated as a case of primary lung cancer, report the lung diagnosis as a separate primary. |
2015 | |
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20150002 | Reportability--Bladder: Please explain the reportability of UroVysion for bladder cancer in the following circumstances.
1. Patient has positive UroVysion test and follow up biopsy is negative. Is this case reportable with a diagnosis date the date of the UroVysion?
2. Patient has positive UroVysion test and follow up biopsy is positive for cancer. Is the diagnosis date of the date of the positive UroVysion or the date of the positive biopsy? Thank you. |
Do not report a case based on UroVysion test results alone. Report a case when there is positive histology, a physician statement of malignancy, and/or the patient was treated for cancer.
1. Do not report the case.
2. Report the case based on the positive biopsy. |
2015 |
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