Reportability/Recurrence (Pre-2007)--Bladder: If a patient has had recurrent invasive bladder cancers since 1971, should the latest recurrence in 2003 be SEER reportable because the case has yet to be reported to SEER?
For tumors diagnosed prior to 2007:
Because this 2003 recurrent bladder cancer was initially diagnosed prior to 1973, it is not reportable to SEER.
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.
Multiple primaries--Heme & Lymphoid Neoplasms: Is this 2 primaries? In 2011, a patient had a spinal mass biopsied positive for DLBCL and follicular lymphoma. The heme rules make this one primary coded as DLBCL. Patient had 2 rounds of chemo, but in 2014, he had a recurrent tumor in the same location. The 2014 biopsy was follicular lymphoma. Is this a new primary -- conversion of acute to chronic after treatment? Or is it the same, since FL was diagnosed in the original specimen?
Rule M13 applies, abstract as two primaries. Since both DLBCL and FL were present in 2011, rule M2 does not fit -- not a single histology. Rule M13 reflects the situation in this case much better: an acute neoplasm which was treated and a chronic neoplasm diagnosed later.
Reportability/Behavior Code--Soft Tissue: Is a final diagnosis of a forearm mass diagnosed as "Angiomatoid malignant fibrous histiocytoma [see note]" reportable? The NOTE reads "Angiomatoid malignant fibrous histiocytoma is a low grade borderline lesion with a tendency for local recurrence, but a very low potential for distant metastases." Is behavior /1 or /3?
Angiomatoid malignant fibrous histiocytoma is reportable with a behavior code of /3 according to ICD-O-3. The Final Diagnosis takes precedence over the "note."
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.
Reason for No Cancer-Directed Surgery: Could you explain why this field would be coded to 1 [Cancer-directed surgery was not recommended] or 2 [Contraindicated due to other conditions] for a case that presents with distant metastasis at diagnosis?
For cases diagnosed 1998-2002:
Code the Reason for No Cancer-Directed Surgery field to 1 [Cancer-directed surgery was not recommended] for patients who present with either a primary site or histology for which surgery is not a standard treatment. Also use code 1 for those patients who present with distant disease for a primary site that is typically treated surgically. Patients with distant metastasis typically do not have surgery performed as part of first course of treatment.
Code 2 [Contraindicated due to other conditions] is used when surgery would normally be recommended for the site (given the current stage of the tumor) but other medical conditions pose too much of a risk for the patient to undergo surgery.
Multiple Primaries--Urinary: How many primaries should be coded for an 8/9/07 invasive transitional cell carcinoma of right ureter; 7/9/08 non-invasive urothelial carcinoma of bladder; 11/18/08 non-invasive urothelial carcinoma of left ureter; 6/20/09 invasive urothelial carcinoma of left ureter?
One primary. This is a good example of how the field effect occurs in the urinary system. From 2007 to 2008, Rule M8 says bladder and ureter tumors are not new primaries and would be documented as recurrences. Because other urinary sites are involved by 11/08 and by 06/09, do not make second primary of left ureter (Rule M4 does not apply).
EOD Fields--All Sites: Is EOD information limited to what is available exactly two months from the day of diagnosis?
For cases diagnosed 1998-2003:
EOD should include all information available within four months of diagnosis in the absence of disease progression or through completion of surgery(ies) in first course of treatment, whichever is longer.
Mets known to have developed after EOD was established should be excluded.
Reactive plasmacytosis is not reportable unless there is another indication of a reportable neoplastic disease. Reactive plasmacytosis is "a well known pathological process described as occurring in a variety of situations including infections, autoimmune disease, diabetes mellitus, sideropenia, liver cirrhosis and neoplastic conditions including leukemia. This process, by definition, is assumed to be a reaction of the immune system to an unknown or poorly defined stimulus." Based on this definition, reactive plasmacytosis is not the same as a plasmacytoma, although it may indicate the presence of a neoplastic process, such as leukemia.
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.
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