Report | Question ID | Question | Discussion | Answer | Year |
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20200049 | Summary Stage 2018/EOD 2018--Lymphoma Orbital Adnexa: What is the correct Summary Stage 2018 (SS2018) for the site/histology Orbit, NOS (C696), 9699/3? In SEER*RSA, Extent of Disease (EOD) Primary Tumor references code 7 (Distant), whereas SS2018 assigns code 2 (Regional)? See Discussion. |
We received an edit error in SEER*DMS on the following site/histology (Orbit, NOS (C696)/9699/3) that involved an incorrect staging code being assigned to SS2018. The staging language is identical in AJCC, EOD and SS2018. SEER*RSA notes that SS2018 should be coded distant, but in the SS2018 manual, this language is noted Regional. Staging language is: Orbital adnexal lymphoma AND extraorbital lymphoma extending beyond the orbit to adjacent structures--Bone, Brain, Maxillofacial sinuses |
To clear this edit of the derived Summary Stage (based on EOD) and the manually assigned Summary Stage (based on Summary Stage 2018), assign the manually assigned Summary Stage to 7. For this particular case, EOD Primary Tumor 700 (which is correct based on the information received) derives Distant; however, for Summary Stage 2018, this description is under Code 2 for Regional by direct extension. This is an error. For 2022, Summary Stage for Lymphoma Ocular Adnexa description under Code 2 (Regional by direct extension) will be moved to Distant. No changes will be done to EOD. |
2020 |
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20150048 | Reportability--Skin: Is low grade trichoblastic carcinoma, with a small focus of high grade carcinoma of the scalp reportable? See discussion. |
Pathology report states: the individual nodules of trichoblastic cells resemble those seen in trichoblastoma, but the lesion is very poorly circumscribed with an infiltrative border that extends into the subcutis. the lesion may behave in a locally aggressive fashion, and should be completely removed. High grade trichoblastic carcinomas can metastasize. |
Trichoblastic carcinoma of the skin is not reportable. The WHO classification lists trichoblastic carcinoma as a synonym for basal cell carcinoma, 8090/3. Basal cell carcinoma of the skin is not reportable. See page 11 in the SEER manual, http://seer.cancer.gov/manuals/2015/SPCSM_2015_maindoc.pdf. |
2015 |
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20170024 | Reportability/Histology--Colon: Is tubular adenoma with high grade dysplasia and focal invasion from a pathology report of a colon biopsy reportable?; if so, what is the histology code? |
Tubular adenoma with high grade dysplasia and focal invasion is reportable. Assign the histology code and behavior as 8210/3 (Adenocarcinoma in tubular adenoma). NAACCR Guidelines for ICD-O-3 Implementation discuss the term high grade dysplasia (without invasion). High grade dysplasia and related terms are under review and study for consideration as a reportable neoplasm. Registries should check with their state reporting legislation to see if included in the reporting requirements. |
2017 | |
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20061086 | Reportability--Melanoma: Is an excisional biopsy of the skin with a diagnosis on the pathology report of "Tumoral melanosis" reportable by itself or must there be a pathologist note, such as "Note: Unless proven otherwise, tumoral melanosis should be considered as a regressed melanoma", in order for it to be reportable? See Discussion. |
Skin, left upper back, exc Bx: Tumoral melanosis. Note: Unless proven otherwise, tumoral melanosis should be considered as a regressed melanoma. If reportable, do we report a diagnosis of tumoral melanosis without a similar note? |
Tumoral melanosis (TM) alone is not reportable. It is not listed in ICD-O-3. TM can be associated with a regressed melanoma, but it can also occur with other cutaneous tumors. The case is reportable if there is a diagnosis of melanoma. |
2006 |
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20021187 | Reportability: When a hospital pathologist sends the slides from an original biopsy to two or more outside reviewers and the reviewers differ on whether or not the case is reportable, is the case SEER reportable? Does the decision to treat the patient have any bearing on whether the case would be reportable? |
Typically, the final diagnosis of the reviewing pathologist is the one used to determine whether the case is SEER reportable. If two or more reviewing pathologists disagree as to whether the case should be reportable, determine reportability based on the following priority order: 1) If the patient is treated for cancer, the case is reportable. 2) If the patient is not treated for cancer, use the amended diagnosis on the original pathology report if the hospital pathologist used the reviewing pathologists' opinions in establishing his new diagnosis. 3) If there is not an amended diagnosis for the original hospital pathology report, use the clinician's opinion regarding what the diagnosis is to determine whether the case is reportable. |
2002 | |
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20200031 | Histology/Behavior--Breast: How are histology and behavior coded for a case originally diagnosed as in situ and later an invasive tumor with a different histology is diagnosed but still a single primary using Breast Solid Tumor Rule M10? See Discussion. |
SINQ 20200022 indicates that cases originally diagnosed as in situ do not have a new primary when a new invasive tumor with a different histology is diagnosed within 5 years. Should histology and/or behavior get updated for the in situ breast primary? |
Update the histology and behavior based on the invasive tumor when an invasive tumor is diagnosed within 5 years of an in situ tumor in the same breast. This will be updated in the 2021 revisions of the Breast Solid Tumor Rules. |
2020 |
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20220042 | First Course Treatment/Radiation Therapy: How should Lutathera be coded? CoC states XRT- Radioisotopes and SEER states Other Treatment. |
Lutathera is a radioconjugate consisting of the tyrosine-containing somatostatin analog Tyr3-octreotate (TATE) conjugated with the bifunctional, macrocyclic chelating agent tetra-azacyclododecanetetra-acetic acid (DOTA) and radiolabeled with the beta-emitting radioisotope lutetium Lu 177 with potential antineoplastic activities. |
Update to the current manual: Code Lutathera as radiation (isotopes NOS code 13). We will make this change in the next version of the SEER manual. |
2022 |
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20010094 | Reportability/Ambiguous Terminology--Breast: Should the American College of Radiology (ACR) BI-RADS assessment categories 4 [Suspicious Abnormality--biopsy should be considered] and 5 [Highly Suggestive of malignancy-appropriate action should be taken], impressions for mammograms and sonograms, be used as the sole basis for reportability? See discussion. |
ACR website: Category 4: Lesions that do not have the characteristic morphologies of breast cancer but have a definite probability of being malignant. Category 5: lesions have a high probability of being cancer. |
Updated Answer Please refer to Appendix E of the SEER Program Coding Manual for the most up-to-date information, https://seer.cancer.gov/manuals/2018/SPCSM_2018_AppendixE.pdf |
2001 |
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20190072 | Solid Tumor Rules (2018)/Histology--Lung: What is the correct histology code for minimally invasive adenocarcinoma in the lung, 8140/3 or 8256/3? See Discussion. |
For example, 9/12/18 left lung upper lobe lobectomy: 1.5 cm, 0.8 cm invasive component, lepidic predominant adenocarcinoma with acinar and lepidic patterns, G2, no visceral pleural invasion, no LVI, 0/14 LNS positive. An additional minimally invasive adenocarcinoma, 1 mm, was seen away from the main tumor. The correct coding of the minimally invasive adenocarcinoma will ultimately determine if we have one tumor (using rule M7) versus two primaries (using rule M6). |
Updated answer: Code minimally invasive adenocarcinoma, NOS as 8140/3. This is a new term and code in the 2018 ICD-O-3 New Codes, Behaviors, and Terms-Updated 8/22/18 list. See Solid Tumor Lung Table 3, and Solid Tumor Lung rules H1 and H10. |
2019 |
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20170023 | Reportability/Date of Diagnosis--Prostate: Is PI-RADS 5 diagnostic of prostate cancer, and if so, can we use the date of the impression on the scan that states PI-RADS category 5 as the diagnosis date? See Discussion. |
We are seeing more use of PI-RAD categories on scans. The final impression on the scan will be PI-RADS Category 5, with no specific statement of malignancy. The scans include a blanket statement with the definitions of the PI-RADS categories as below. PI-RADS (v2) categories: PI-RADS 1 - Very low (clinically significant cancer is highly unlikely to be present) PI-RADS 2 - Low (clinically significant cancer is unlikely to be present) PI-RADS 3 - Intermediate (the presence of clinically significant cancer is equivocal) PI-RADS 4 - High (clinically significant cancer is likely to be present) PI-RADS 5 - Very high (clinically significant cancer is highly likely to be present) A previous SINQ 20010094 indicates that we cannot use BI-RADS categories for breast cancer diagnosis, and SINQ 20160008 indicates we can use LI-RADS for HCC diagnosis, but those definitions are slightly different. Most often there will be a subsequent biopsy diagnosis of carcinoma, so the question is also in reference to Diagnosis Date. Can we use the date of the scans impression, which states PI-RADS category 5, as the Diagnosis Date? |
Updated answer PI-RADS categories 4 and 5 are reportable, unless there is other information to the contrary. PI-RADS 4: high (clinically significant cancer is likely to be present) PI-RADS 5: very high (clinically significant cancer is highly likely to be present) Use the date of the scan as the date of diagnosis. |
2017 |