MP/H--Bladder: Are 8130 and rule H12 correct for this case? Bladder with papillary urothelial carcinoma with squamous cell differentiation.
Rule H8 applies, code the histology with the numerically higher ICD-O-3 code which is papillary transitional cell carcinoma, 8130.
Based on the information provided, there is a single bladder tumor, papillary urothelial carcinoma with squamous cell differentiation. Urinary sites rule H12 does not apply because this is a single tumor, not multiple tumors. In the single tumor H rules, H3 does not apply as this rule does not include papillary transitional cell carcinoma. Rule H4 is papillary carcinoma or papillary transitional cell carcinoma and refers you to Table 1. Table 1 does not list papillary urothelial carcinoma with squamous cell differentiation because there is no ICD-O-3 code for this histology. Table 1 does list transitional cell carcinoma with squamous differentiation as code 8120, however, the papillary transitional cell carcinoma is the higher code, 8130. We will review this situation for the next version of the rules.
Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])?
For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS].
SEER Manual/Reportability--Vulva: Is vulvar intraepithelial neoplasia (VIN II) alone reportable? An example is a final diagnosis from a pathology report that states only 'VIN II' with no additional details/wording.
Report VIN II. The 2024 SEER Manual lists this as a separate diagnosis in the Reportability section under Malignant Histologies 1.a.x.
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.
CS Extension--Lung: How is this field coded for a tumor in the right middle lobe with extension to the bronchus intermedius?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
Assign CS extension code 20
[Extension from other parts of lung to main stem bronchus, NOS
(EXCLUDES superficial tumor as described in code 11)
Tumor involving main stem bronchus greater than or equal to 2.0 cm from carina (primary in lung or main stem bronchus)].
A right middle lobe tumor that extends to the bronchus intermedius is one that is extending to the main stem bronchus from another part of the lung. The bronchus intermedius is the lower part of the main stem bronchus on the right. It is more than 2.0 cm away from the carina.
Reportability--Cervix: The SEER Program Code Manual lists CIN III and carcinoma in situ of the cervix as not being reportable for cases diagnosed in 1996 or later, but does not list "adenocarcinoma in situ" or "squamous cell carcinoma in situ." Are these histologies still reportable?
For primary site cervix uteri, only histologies with behavior codes of 3 [invasive] are reportable to SEER for all registries.
Some SEER registries have opted to continue to collect behavior codes of 2 [in situ] for cervix uteri primaries.
EOD-Extension/EOD-Lymph Nodes--Cervix: How do you code these fields when the cancer extended to the pelvic wall and there are periaortic LN metastases?
For cases diagnosed 1998-2003:
Assign extension code 65 for contiguous (direct) extension of tumor from the cervix to the pelvic wall. Assign extension code 85 only if the pelvic wall is involved with discontinuous extension from the cervix; i.e., the cervical tumor spread indirectly (through lymph or vascular channels) to the pelvic wall. Code the pelvic wall involvement in the Extension field and the periaortic lymph node involvement in the Lymph Node field. When the computer does the algorithm, it will look at the periaortic lymph nodes and report the summary stage as distant and the TNM stage group as IV because periarotic nodes are M1. Do not code the periaortic lymph nodes in both fields. This is stage IV, distant disease, due to the periaortic lymph node involvement (EOD lymph nodes code 6).
CS Extension--Bladder: How should this field be coded for a high grade urothelial carcinoma with "focal micropapillary features and invasion of lamina propria, with a note stating there is invasive carcinoma focally involving thin muscle bundles...difficult to distinguish whether muscularis propria or muscularis mucosae"?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign CS Extension code 15 [Invasive tumor confined to subepithelial connective tissue (tunica propria, lamina propria, submucosa, stroma)]. The information provided confirms invasion of the lamina propria (code 15) but is not definitive enough to assign a code higher than 15.
CS Extension/CS Mets at Dx--Wilm's Tumor: Is the fact that a Wilm's tumor case is bilateral captured in the CS Extension field or is the CS Mets at Dx field coded to 40?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Code laterality as bilateral, code the greatest extension from either side in CS extension.
Code CS Mets at diagnosis 00 [None] UNLESS true distant metastases were identified.
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