System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 11/08/2026 02:02 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20031067 Primary Site/Histology (Pre-2007)/Sarcoma: How do you code these fields for a vulvar tumor diagnosed by FISH analysis as "extra-osseous Ewing sarcoma?" See Description. A literature search relates soft tissue malignancy described as "extra-osseous Ewing sarcoma/PNET." Neither are compatible with site.

For tumors diagnosed prior to 2007:

Code histology as 9260/3 [Ewing sarcoma]. ICD-O-3 does not have a code for extra-osseous Ewing sarcoma (EOE). Ignore the topography code listed in ICD-O and use the code for the primary site (vulva).

Site codes associated with morphology codes in the ICD-O are the most common sites and are not intended to limit coding only to those sites.

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.

 Sarcoma Histology, Primary site 2003
20031182 Date of Diagnosis/Diagnostic Confirmation: How are these fields coded when a physician statement of diagnosis predates a positive biopsy? See Description. A mass seen on EGD with negative biopsy 12/28/01. Needle core biopsies 1/14/02 were diagnostic of GIST. Gleevec treatment was initiated 2/02, and in discharge summary 5/27/02, the physician says the GIST was diagnosed on EGD. Code the date of diagnosis as 01/2002. Code the diagnostic confirmation as positive histology. EGD revealed a "mass." Biopsies of the "mass" seen on EGD were negative before January 2002. N/A Date of diagnosis, Diagnostic confirmation 2003
20041006 Multiple Primaries (Pre-2007)/Date of Diagnosis--Bladder: How is date of diagnosis coded when metastases consistent with a bladder primary are found more than a year after a diagnosis of non-invasive bladder cancer? See Description. A non-invasive papillary transitional cell carcinoma is removed by TURB in May 2002. In January 2003, a bone biopsy reveals metastatic transitional cell carcinoma consistent with bladder primary.

For tumors diagnosed prior to 2007:

Code a second bladder primary diagnosed in January 2003.

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.

 Bladder Date of diagnosis 2004
20081120 MP/H Rules--Sarcoma: How many primaries should be abstracted for chondrosarcoma of right toe in 2002, of right lower leg in 2006 and right tibia in 2007? See Discussion. A patient had a myxoid chondrosarcoma of the right toe in 2002. This was amputated and staged as T2 - high grade. Patient had a recurrence in the lower right leg in 2006. At this time he had a below knee amputation. The tumor in 2006 was stated to be similar histologically to the 2002 tumor with pathologic comparison done. Then in 2007 the patient presents with pain in right knee and stump. CT says compatible with recurrent disease, but no copies of path sent. Patient then had an above knee amputation, with diagnosis of clinically recurrent chondrosarcoma of tibia. How many primaries should be abstracted? Is 2007 diagnosis a new primary?

For cases diagnosed 2007 or later:

Abstract two primaries in this case, 2002 and 2007.

The first primary was diagnosed in 2002. The 2006 diagnosis would not be a new primary according to the rules in effect at that time (2004 SEER manual, page 11, rule 5, exception 1).

Use the current MP/H rules to compare the 2007 diagnosis to the 2002 diagnosis. Start with rule M3 and stop at rule M10. The 2007 diagnosis is a separate primary.

 Sarcoma N/A 2008
20041012 Multiple Primaries (Pre-2007)--Colon: What is the number of primaries for a case of familial polyposis with at least three separate tumors having invasive adenocarcinoma, one in the rectum? See Discussion. A patient had a total proctocolectomy and was found to have familial polyposis. At least 3 separate tumors were identified with invasive adenocarcinoma, one of which was in the rectum. Is this 2 primaries: C18.9 with 8220/3 and C20.9 with 8140/3 or is this all one primary cancer?

For tumors diagnosed prior to 2007:

Familial polyposis is always a single primary. Code the primary site for the case example above to C199 [colon and rectum].

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.

 Colon N/A 2004
20071077 MP/H Rules/Multiple Primaries/Histology--Colon: How many primaries should be reported and how is the histology field(s) coded if the left colon contains two adenocarcinomas and one mucinous adenocarcinoma arising in a villous adenoma and each has a different level of invasion? See Discussion. A patient had three tumors in the left colon including an 1) invasive well differentiated mucinous adenocarcinoma arising in tubulovillous adenoma with pericolonic subserosal fat invasion 8.5cm, 2) An infiltrative moderately differentiated colonic adenocarcinoma with invasion of muscularis propria 4cm and 3) an invasive moderately differentiated adenocarcinoma with invasion of muscularis propria, 1/69 nodes positive. The case was coded using rule M8 for one primary, but M10 contradicts; and H13 coding rule for histology 8263/3.

For cases diagnosed 2007 or later:

Assuming that all tumors are in the left colon, there are three tumors:

  • Mucinous adenocarcinoma arising in a villous adenoma

  • Colonic adenocarcinoma

  • Colonic adenocarcinoma

    • Multiple Primary Determination

    In the colon MP rules go to the multiple tumors module. Start with M3. Stop at M7 and abstract as a single primary.

    Histology Code

    Go to the histology coding rules, multiple tumors module, and start with H15. Stop at H20 which tells you to code the most invasive tumor. Tumor 1 is the most invasive according to the definition of most invasive in the 2007 SEER Manual, page C-271. Code 8263/3 [Adenocarcinoma in tubulovillous adenoma].

    		 Colon N/A 2007
    		20041065 Date Therapy Initiated/First-Course of Cancer-Directed Therapy Fields/Summary Stage 2000--Prostate: How do you code these fields for a case that received preventative chemo before a definitive cancer diagnosis? A patient has a "suspicious but not diagnostic" biopsy of the prostate in 09/2002. Doctor said it was not cancer and put the patient on a preventative chemo drug study (GTX-211). The patient returned for a repeat biopsy on 04/2003. Biopsy returned positive for adenocarcinoma. The patient had not been diagnosed when chemo was administered. Can the case be staged using the post-chemo information?

    Stage this case the same as all other cases. Use only the information subsequent to the date of diagnosis to code stage and treatment.

    The diagnosis date in the example is 04/2003. Do not use information prior to 04/2003 to code stage or treatment. Do not code the preventative chemo as treatment.

    		 Prostate First course treatment 2004
    		20100022 Multiple primaries/Histology--Heme & Lymphoid Neoplasms: Is a 2010 diagnosis of ALK+ anaplastic T cell lymphoma following a 2008 diagnosis of follicular B cell lymphoma, grade 1 a new primary? If so, how is the histology coded? See Discussion. A patient has a history of Stage 4 follicular B cell lymphoma, grade 1 [9695/3] diagnosed in 2008. The patient was treated with Adriamycin, Cytoxan, Rituxan, and Prednisone. In 2010, the medical oncologist states the patient has progression/recurrence of lymphoma with pathology that has changed to anaplastic T cell lymphoma ALK+. There was immunophenotyping, but there was no more specific diagnosis made. The patient died within 3 months.

    Updated May 2026

    Rule M15 applies to this case which instructs you to use the Multiple Primaries Calculator. The result for 9695/3 and 9714/3 is "New Primary."

    Abstract the anaplastic T cell lymphoma as a new primary. Code the histology to 9714/3 [Anaplastic large cell lymphoma, ALK-positive].

    		Heme & Lymphoid Neoplasms Histology 2010
    		20110077 MP/H Rules/Multiple primaries--Breast: How many primaries are to be reported if different recurrence scores are found on the Oncotype Dx studies performed for multiple tumors in the same breast if the clinician states the patient has two primaries but the pathologist does not address the issue? See Discussion. A patient has two separate lesions in the same quadrant with the same histology. According to the MP/H rules this is a single primary. However, Oncotype Dx studies were performed on both tumors and the DX recurrence was different for each tumor. The medical oncologist states the patient has two primaries. The pathologist does not indicate the number of primaries.

    This is a single primary. The only rules used to determine the number of primaries are the MP/H rules for cases diagnosed 2007 or later. Do not use other information such as Oncotype Dx to determine the number of primaries for a patient. Oncotype is used to determine whether the cancer is likely to recur AND whether the cancer would benefit from chemotherapy.

    The steps used to arrive at this decision are:

    Open the Multiple Primary and Histology Coding Rules manual. Once in the manual, locate the Breast MP rules under one of the three formats (i.e., flowchart, matrix or text).

    Start with the MULTIPLE TUMORS module, Rule M4. The rules are intended to be reviewed in consecutive order within the module from Rule M4 to Rule M13. You stop at the first rule that applies to the case you are processing.

    The patient has two tumors in the same breast with the same histology. Abstract a single primary for this patient.

    		Breast N/A 2011
    		20100082 Ambiguous terminology/Reportability--Heme & Lymphoid Neoplasms: Should a case be accessioned as MDS, NOS when a consult uses ambiguous terminology (e.g., probable MDS) to describe the disease process and the bone marrow does not confirm the consult diagnosis? See Discussion. A patient is stated to have "probable MDS" by a hematology oncologist consult during an admission. A bone marrow biopsy was also performed during this admission, the final diagnosis on the pathology report is, "anemia and thrombocytopenia." The patient was not seen again by a hematology oncologist; however the patient's cardiology states, "BM biopsy was not clear whether this is MDS or another etiology."

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    This is not reportable. In effect, the original diagnosis was a rule/out MDS diagnosis. The bone marrow biopsy performed as part of the initial workup, proved that rule/out diagnosis was not valid. The subsequent statement confirms the diagnosis is not clear.

    SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

    		Heme & Lymphoid Neoplasms N/A 2010