Computed Ethnicity: Should the Name--Alias field be used when generating Computed Ethnicity?
No, "Alias" is not used and should not be used to generate Computed Ethnicity. Computed Ethnicity records the ethnicity based on last name and/or maiden name using a computer algorithm. Alias is not part of the algorithm.
Radiation Therapy--Breast: If hospital records indicate that a mammocyte intracavitary radiation therapy device was placed in the breast, but there is no follow-up documentation of radiation actually being given, should we code radiation 2 (implants) or 8 (recommended, unknown if given)?
Assign code 8 [recommended, unknown if administered]. Check this case periodically, and others coded 8. Update if further information becomes available.
Reportability/Histology--Tongue: Is high grade squamous dysplasia of the tongue reportable; and is it the same as carcinoma in situ (CIS), code 8077/2?
High grade squamous dysplasia of the tongue is reportable as of 2021 and later as 8077/2.
First course treatment/Chemotherapy: Is metronomic chemotherapy coded as chemotherapy?
Code metronomic chemotherapy as chemotherapy. Metronomic chemotherapy, also referred to as low-dose metronomic (LDM) chemotherapy, is an emerging cancer treatment approach which administers relatively low doses of traditional chemotherapy drugs over a long period of time and without ‘breaks’ in treatment. By using lower doses this method of treatment minimizes the side effects of traditional chemotherapy.
Laterality--Head and Neck: Were the topography codes C090 and C091 intentionally left off of the Sites for Which Laterality Codes Must Be Recorded table in the 2018 SEER Manual? The codes were also removed from Table 10 in the 2018 Solid Tumor Rules for Head and Neck but appear under coding instructions 1b. and 6b. in the manual.
Thank you for bringing this to our attention. C090 and C091 were intentionally removed from the list of sites for which laterality must be coded. They should have also been removed from coding instructions 1b and 6b. We will make that correction in the next version of the manual.
Reportability--Hematopoietic, NOS: Is a "myeloproliferative disorder" reportable when the pathology report comment states this likely represents the "early/cellular phase of myelofibrosis/myeloid metaplasia" with cytogenetics and PCR pending?
For cases diagnosed prior to 1/1/2010:This case is not yet reportable. The bone marrow diagnosis "myeloproliferative disorder" is not reportable to SEER. It is likely that if this condition progresses, it will eventually be reportable.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded, and which PH rule applies, when chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is diagnosed simultaneously by biopsies of both lymph node(s) and the bone marrow?
Code the primary site to C421 [bone marrow] per Rule PH5 when CLL/SLL [9823/3] involves the bone marrow.
In the later stages of CLL/SLL, there may be involvement of bone marrow AND lymph node(s), lymph node region(s), organ(s), or tissue(s). As long as the peripheral blood and/or bone marrow are involved, the primary site is bone marrow.
WHO states that the diagnostic criteria for CLL versus SLL is not clearly defined. According to WHO guidelines, it is better to code to CLL/SLL and code the primary site to bone marrow when the marrow is involved and to lymph nodes, organ, or tissue when there is no bone marrow involvement.
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.
Reportability/MP/H Rules/Histology: Is malignant perivascular epithelioid cell tumor (PEComa) reportable, and if so, what is the histology code?
Malignant perivascular epithelioid cell tumor (PEComa) is reportable because it is malignant. Assign 8005/3 to malignant PEComa.
We consulted an ICD-O-3 expert who explained that some PEComas such as angiomyolipoma and lymphangiomyomatosis have specific ICD-O codes and their malignant counterparts may be coded to 8860/3 and 9174/3 respectively. There are no separate ICD-O codes for other specific PEComas, e.g., clear cell “sugar” tumor of lung, clear cell myomelanocytic tumor of the falciform ligament and some “unusual” clear cell tumors occurring in other organs—or for PEComa, NOS. These PEComas may therefore be coded to 8005 as clear cell tumors NOS; in other words as clear cell tumors that are not clear cell variants of carcinomas, sarcomas, or other specific tumor type.
Please note, PEComa is non-specific as to behavior. Unless the pathologist states that it is malignant, (as was the case for this question), the default code is 8005/1 (non-reportable).
Date of Diagnosis: When doing follow-back at nursing homes on DCO cases, we find it difficult to code diagnosis date because the nursing home records are often vague or incomplete. Should the diagnosis date be coded as unknown (excluded from SEER database), the date of death, or the approximate date of diagnosis as reported on the death certificate?
If the nursing home record indicates that the patient had cancer, use the best approximation for date of diagnosis.
If the record says the patient had cancer when admitted, but it does not provide a date of diagnosis, use the date of admission as the date of diagnosis.
If there is no mention of cancer in the nursing home record and/or all work-up in the record is negative, assume the cancer was discovered at autopsy. Use the date of death as the date of diagnosis, and leave as a Death Certificate Only case.
EOD 2018/EOD Primary Tumor--Cervix: How is Extent of Disease (EOD) Primary Tumor of the cervix coded when it invades into the bladder on surgery and noted as T4. No further information is provided, and it is not possible to contact the physician for clarification. Would you code 550 (Bladder wall; bladder, NOS excluding mucosa), 750 (Bladder mucosa), or 999 Unknown?
Assign code 550 (Bladder, NOS excluding mucosa) to EOD Primary Site based on invasion into the bladder with no mention of mucosa. EOD Primary Tumor for cervix, Note 1, instructions are to use the extension information to code primary tumor in preference to a statement of FIGO stage when both are available. TNM staging is closely related to FIGO stage, and the surgical findings of bladder invasion NOS in this case should be used in preference to the statement of T4.
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