| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20081044 | MP/H Rules/Behavior--Melanoma of Skin: How are histology and behavior coded for a "malignant melanoma in situ with regression"? See Discussion. | Per the microscopic portion of the path report, there is a zone of regression within the confines of the lesion, such that the possibility of antecedent invasive disease at the site cannot be ruled out with certainty. | For cases diagnosed 2007 or later: Code malignant melanoma in situ with regression to 8720/2 [Melanoma in situ]. Code the histology according to the histologic type specified in the pathology report final diagnosis. Code the behavior as specified in the pathology report. Regression does not affect the coding of histology or behavior. See Melanoma Histology Coding rule H5. See 2007 SEER manual instructions for coding behavior, page 84. |
Melanoma | Behavior | 2008 |
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20081045 | MP/H Rules--Melanoma: How is histology coded for a regressing melanoma? See Discussion. | How is histology to be coded for the following tumors? Example 1: Path showed malignant melanoma Histologic type: superficial spreading. Regression: present. Example 2: Shave, mid back: malignant melanoma, lentigo melanoma type, level II, regression: present and prominent. |
For cases diagnosed 2007-2014: Apply MP/H Melanoma Histology Coding rule H5 and code the histologic type of the melanoma. Code example 1 as 8743 [Superficial spreading melanoma]. Code example 2 as 8742 [Lentigo maligna melanoma]. |
Melanoma | Histology | 2008 |
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20021205 | EOD-Extension--Melanoma: Is "erosion" synonymous with "ulceration" for melanoma cases? | For cases diagnosed 1998-2003:
No, do not interpret the term "erosion" as a synonym for "ulceration" when coding the EOD-Extension field for melanoma. According to AJCC's melanoma curator, erosion is not necessarily the same as ulceration. |
Melanoma | N/A | 2002 | |
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20110040 | Reportability--Melanoma: Is a pathology report with a final diagnosis stating only non-reportable terms, followed by a re-excision pathology report that indicates "no residual melanoma" reportable? See Discussion. |
Is a case reportable if the final diagnosis on an initial pathology report states a non-reportable term (e.g., evolving melanoma, early/evolving melanoma or melanocytic nevus) and followed by a subsequent re-excision pathology report stating there is "No residual melanoma"? There is no mention in the clinical history on the subsequent pathology report that the diagnosis was thought to be melanoma following the first procedure. The first mention of the reportable term was in the final diagnosis of the subsequent pathology report that stated "no residual melanoma." |
No. This case is not reportable based on the information provided. "No residual melanoma" is not diagnostic of a reportable neoplasm. We recommend that you try to obtain more information from the clinician/pathologist for this case due to the poor documentation. Check for any additional resection performed. |
Melanoma | N/A | 2011 |
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20091029 | MP/H Rules/Histology--Melanoma: How should histology be coded for a melanoma arising in a compound nevus, NOS or a nevus, NOS? | For cases diagnosed 2007 or later, assign code 8720 [Melanoma, NOS] to melanoma arising in a nevus that does not have a specific code or to melanoma arising in a nevus, NOS. Currently, ICD-O-3 does not have a specific classification for a melanoma arising in a compound nevus. |
Melanoma | Histology | 2009 | |
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20160054 | MP/H Rules/Multiple primaries--Melanoma: How many melanoma primaries should be abstracted if, during the workup for a metastatic melanoma of an unknown cutaneous site, an in situ melanoma is also discovered? See Discussion. |
Patient has diagnosis of melanoma with spindle cell features found in a right lower lobectomy specimen. Chart notes indicate this is metastatic from a cutaneous primary of unknown site. Further work up includes a biopsy of the tip of the nose, which is diagnostic for in situ melanoma. Should this be abstracted as two separate primaries, one for an invasive melanoma of unknown primary site and the other for an in situ melanoma of the skin on the tip of the nose? Which MP/H Rule would apply? |
Yes, abstract this as two separate primaries, an invasive melanoma of unknown primary site and an in situ melanoma of the skin on the tip of the nose. Rule M3 applies. |
Melanoma | N/A | 2016 |
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20170030 | Surgery Primary Site--Melanoma: How should Surgery of Primary Site be coded for a melanoma diagnosed on punch or shave biopsy followed by a wide excision that shows no residual disease and the gross wide excision specimen size showing no residual is greater than 1 cm in all dimensions (length, width and depth)? See Discussion. |
Discussion: Example: Shave biopsy with superficial spreading melanoma, Breslow 0.25 mm, Clark level II. Excision with no residual melanoma and gross description of specimen size is 4.0 x 1.6 cm skin ellipse excised to a depth of 1.8 cm. We have differing opinions in our registry. Opinion 1: We can assume margins are greater than 1 cm based on the excision specimen size when there is no residual tumor on excision and all dimensions of the excision specimen are more than 1 cm. Surgery would be coded in 40s range. Opinion 2: We should assume the melanoma defect was in the middle of the excision specimen, so for a skin ellipse that is 4.0 x 1.6 cm, there would be a 2 cm and 0.8 cm margin (respectively) from the middle of the specimen, thus margins are not > 1 cm. Surgery would be coded in 30s range. |
Assign code 30: Biopsy of primary tumor followed by a gross excision of the lesion. The margins are unknown. The registrar should not try to determine the margins when they are not specified. See the SEER Note at the top of page 2 in the Skin Surgery Codes section of Appendix C of the SEER manual "If it is stated to be a wide excision or reexcision, but the margins are unknown, code to 30." https://seer.cancer.gov/manuals/2016/AppendixC/Surgery_Codes_Skin_2016.pdf |
Melanoma | Surgery of Primary Site | 2017 |
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20160017 | Surgery of Primary Site--Melanoma: Please further explain the SEER Note under Melanoma surgery codes 30-36 for these two examples. Are both examples coded 31? 1. Shave bx: +melanoma in situ, +microscopic margins Wide excision: no residual melanoma in situ 2. Shave bx: melanoma, +microscopic margin Wide excision: Melanoma, margins negative (margin status negative but distance not stated) |
Revised answer: Assign surgery code 30 for both examples based on the SEER Note on the top of page 2 in the Surgery of Primary Site Codes for Skin: If it is stated to be a wide excision or reexcision, but the margins are unknown, code to 30. |
Melanoma | Surgery of Primary Site | 2016 | |
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20190080 | Update to current manual/Surgery of Primary Site/Surgery codes--Melanoma: Can the operative report be used to assess margins if there is no residual melanoma on the wide excision and no margins stated, or if distance is not stated on the pathology report when there is residual melanoma? See Discussion. |
1) Is the operative report only used for margins when the wide excision states no residual disease and no margins are stated on path report? Or do you use the operative report too for margins when the wide excision has residual melanoma and margins are negative but distance is not stated on path report? Does it matter if there was residual melanoma on the wide excision or not as far as using the operative report for margins? 2) Do these rules only apply to melanoma cases or do they also apply to Merkel cell? 3) Did CoC and SEER both agree on this? Are they going to send out an update because this is not how I interpret what is in the STORE manual/SEER manual under the surgery codes. It might be good to send out an official update to the surgical coding rules if this is how we are to code now. |
1. You may take margin information from the operative report if it is missing from the pathology report when assigning the surgery codes for skin.
2. The rule applies to any skin malignancy for which the skin surgery codes apply. 3. SEER, CoC, NPCR, NCRA, NAACCR, and the Canadian registries participated in this decision. SEER is publishing this SINQ question for reference. |
Melanoma | Surgery of Primary Site | 2019 |
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20061117 | Histology (Pre-2007)--Melanoma: Is the code 8740/3 [malignant melanoma in a junctional nevus] to be used when the pathologic diagnosis is "malignant melanoma arising in a compound nevus"? | For tumors diagnosed prior to 2007:
Assign code 8720/3 [malignant melanoma, NOS] for malignant melanoma arising in a compound nevus. A compound nevus is not the same as a junctional nevus. ICD-O-3 does not have a specific code for melanoma in a compound nevus. Assign the code for the type of melanoma specified; for example, NOS, superficial spreading, etc.
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. |
Melanoma | Histology | 2006 |
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