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| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20021136 | Date of Diagnosis/Histology (Pre-2007): How should we code these fields for "atypical fibroxanthoma" of the left cheek diagnosed in October 1999 that is followed by a June 2000 punch biopsy with a microscopic description in the pathology report of "superficial form of malignant fibrous histiocytoma"? See discussion. | Should the diagnosis date for the malignant fibrous histiocytoma be October 1999 because it is called "residual/recurrent atypical fibroxanthoma" in the June 2000 final diagnosis of pathology report? In the microscopic description it is called a "malignant fibrous histiocytoma." Per an August 2000 outpatient note, "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." | For tumors diagnosed prior to 2007:
Code the Histology field to 8830/3 [Malignant fibrous histiocytoma]. Code the Date of Diagnosis to October 1999 based on the clinician's statement of "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." Assume that this statement means that the physician re-evaluated the clinical course and decided that the original tumor must have been malignant.
If the original slides are reviewed and the diagnosis is changed to a malignancy or if the clinician states that the first occurrence was obviously malignant, backdate the date of diagnosis to the first occurrence.
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. |
N/A | Date of diagnosis, Histology | 2002 |
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20150050 | Reportability: Is penile intraepithelial neoplasia, differentiated type, reportable? See discussion. |
Foreskin circumcision shows: Penile intraepithelial neoplasia, differentiated type (differentiated PeIN). If reportable, how would the histology and behavior be coded? Is this behavior /2? |
For cases diagnosed 2018 and later Differentiated penile intraepithelial neoplasia (differentiated PeIN), is reportable (8071/2). Please note: Penile intraepithelial neoplasia, grade 3 (PeIN 3) is also reportable to SEER (C600-C609, 8077/2). |
N/A | N/A | 2015 |
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20071128 | MP/H Rules--Urinary: How many primaries are abstracted when a patient has a May 2000 invasive papillary transitional cell carcinoma of the bladder, a November 2004 invasive papillary transitional cell carcinoma of the right ureter and a May 2007 urothelial carcinoma in situ of both the left and right ureters? | For cases diagnosed 2007 or later: Using the pre-2007 multiple primary rules, the PTCC of the bladder in 2000 and the invasive TCC of the right ureter in Nov. 2004 would have been abstracted as separate primaries.
Use the 2007 MP/H rules to evaluate the May 2007 diagnosis. Start with rule M3. Stop at rule M8. The May 2007 diagnosis is the same primary.
Rule M4 does not apply because of the 2000 bladder primary. A clarification will be added to M4 to stress that for the urinary rules, any urinary tumor up to the present point in time is counted when applying this rule. |
N/A | N/A | 2007 | |
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20160004 | First course treatment/Other therapy: How is Sirolimus (Rapamycin) to be coded when given with known chemotherapy agents in a clinical trial? See discussion. |
The SEER*Rx Database lists Sirolimus as an ancillary agent under the Category section, but as an mTOR inhibitor under the Subcategory. The Remarks section indicates Sirolimus (AKA Rapamycin) is an immunosuppressant, but is also a type of serine/threonine kinase inhibitor. Other types of kinase inhibitors (including Temsirolimus) are types of Chemotherapy. Although the Coding section states this drug should not be coded, Primary Sites (NSCLC and glioblastoma) are listed for this drug. The SEER*Rx Database page for this drug is confusing. Please address the following. 1) Should Sirolimus not be coded when it is being given as a kinase inhibitor or an immunosuppressant? 2) If Sirolimus is ever treatment, should it be coded only for the primary sites listed? 3) If Sirolimus is given as part of a non-blind clinical trial for another site other than NSCLC or glioblastoma, should the Other Therapy field be coded to 2 [experimental - other treatment]? |
Sirolimus is used to treat GVHD (graft versus host disease) and is not coded as treatment. Even though the sub-category is mTOR inhibitor it does not automatically mean it is a chemotherapeutic agent. Sirolimus affects cells differently than Temsirolimus. The chemical compounds differ between these drugs. In order to code rapamycin, the drug given must be stated to be either the analog or ester compound. The SEER*RX database has been corrected and NSCLC/glioblastoma are no longer listed for sirolimus. We researched clinical trials and found several that include sirolimus with other chemotherapy drugs for patients who either have received or will be receiving bone marrow transplants for hematologic diseases. In this case it is not coded. There are a few trials that are looking at sirolimus as a treatment for bladder, prostate, nerve sheath tumors, MDS, and AML. For these cases it would be coded in Other (code 2). |
N/A | First course treatment, Other therapy | 2016 |
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20021178 | Histology (Pre-2007): What code is used to represent the histology "poorly differentiated invasive transitional cell carcinoma with extensive squamous and focal glandular differentiation"? | For tumors diagnosed prior to 2007:
Code the Histology field to 8120/33 [transitional cell carcinoma, NOS, poorly differentiated]. The ICD-O-3 does not have a separate code for transitional cell carcinoma with squamous and/or glandular differentiation.
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. |
N/A | Histology | 2002 | |
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20091087 | Reportability--Appendix: Is a metastatic low-grade appendiceal mucinous neoplasm reportable if the pathologist states that it is a borderline tumor of the appendix? See Discussion. | Low-grade appendiceal mucinous neoplasm; Lt ovary, cul-de-sac, omentum, and small bowel: Metastatic low-grade appendiceal mucinous neoplasm. Per pathologist this is a borderline tumor of the appendix. | Borderline tumors (other than brain and CNS) are not reportable to SEER. In the case of borderline tumors, the term "metastatic" does not automatically make them reportable. When the "metastatic deposits" are also borderline, the case is not reportable. For this case in particular, the "metastases" are actually (benign) implants and not malignant or invasive mets. | N/A | N/A | 2009 |
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20051079 | Reportability/AmbiguousTerminology: Because there is a caveat in the SEER PCM, 3rd edition to ignore adverbs such as "strongly" when assessing reportability, should a term such as "likely" cancerous be reportable given than the expression "most likely" cancerous is reportable? |
"Likely cancerous" is NOT reportable. The CoC, NPCR and SEER have agreed to a strict interpretation of the ambiguous terms list. Terms that do not appear on the list are not diagnostic of cancer. |
N/A | N/A | 2005 | |
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20091093 | Race--How and when is Appendix D, Race and Nationality Descriptions from the 2000 Census and Bureau of Vital Statistics, to be used? See Discussion. |
For example, if race is recorded as unknown on the facesheet of a hardcopy medical record or in the race field of an electronic medical record, how should race be coded for the following descriptions found in the history and physical or consultation reports submitted by clinicians? 1) Patient is Czechoslovakian 2) Patient is born in Czechoslovakia 3) Patient is Ethiopian 4) Patient is born in Ethiopia 5) Patient is Japanese 6) Patient is born in Japan 7) Patient is Brazilian 8) Patient is born in Brazil Would you code these cases any differently if these descriptions were actually used in the race fields in the medical record or on a death certificate? |
Code the patient's stated race when possible. Refer to Appendix D, Race and Nationality Descriptions from the 2000 Census and Bureau of Vital Statistics, for guidance. Use the lists in Appendix D when race is not stated but other information is provided in the medical record. The cases you provide are good examples of the use of Appendix D. They would be coded the same if the descriptions were used in the medical record or death certificate race fields. |
N/A | Race, ethnicity | 2009 |
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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. |
N/A | Surgery of Primary Site | 2015 |
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20021034 | Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma in a tubulovillous adenoma with a mucinous component, the mucinous component is less than 50%"? See discussion. | For mucinous only, the tumor must contain at least 50% mucinous to be coded to the specific histology. | For tumors diagnosed prior to 2007:
Code the Histology field to 8263/3 [adenocarcinoma in a tubulovillous adenoma]. Because the mucinous component involves less than 50% of the tumor, the histology is not coded to mucinous. For mucinous only, the tumor must be at least 50% mucinous, mucin producing, to be coded to the specific histology.
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. |
N/A | Histology | 2002 |
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