Aplastic anemia is not reportable and it is not an alternative name for refractory anemia.
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.
EOD-Extension--Pancreas: How do you code extension when a mass is described on exploratory laparotomy as compressing the duodenum, arising in the head of the pancreas, "extending around" the superior mesenteric vein and artery, and "encasing" the portahepatis?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 40 [extension to peripancreatic tissue, NOS]. Neither of the terms "extending around" nor "encasing" are interpreted as involvement with tumor by SEER.
CS Site Specific Factor--Colon: If the patient has a polypectomy followed by definitive surgery, can a higher CEA reported after the polypectomy but before the colon resection be coded?
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.If the tumor was in the polyp, do not use the post-polypectomy CEA even if it is higher than CEA's prior to the polypectomy. In this situation, the polypectomy would be treatment.
Conversely, if this is a frank adenocarcinoma or the tumor was so invasive that the polyp removed only a portion, use the post-polypectomy CEA because the polypectomy would not be treatment in this situation.
MP/H/Multiple primaries--Stomach: How should I report this case? I reviwed both the MP/H and the Heme Rules and could not determine whether or not this case is multiple primaries in a single site but two histologies and therefore needing two separate abstracts.
Path Diagnosis: Gastric Mass Biopsy: 1) Signet Ring Cell Carcinoma. 2) Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT Lymphoma). 3) Mild Intestinal Metaplasia and Marked Fundic Gland Atrophy, Negative for H Pylori. Comments: Biopsy shows presence of both signet ring carcinoma and MALT Lymphoma.
Report two primaries: MALT lymphoma and signet ring carcinoma. Use the 2007 MP/H rules and the Heme rules for this case.
This case could be an example of a "collision tumor" - two separate tumors that grow together into one mass. Collision tumors are a rare exception to rule M2 in the MP/H rules.
Other Therapy: How do we classify "thalidomide" when it is given as cancer directed therapy?
Code to the appropriate code (1, 2 or 3) under Other Therapy, depending on whether the drug was given as part of a clinical trial. If not part of a clinical trial, assign code 1 [Other cancer-directed therapy].
Thalidomide is not FDA approved for treating cancer. It is under investigation for anti-angiogenesis effects in different cancers.
2004 SEER Manual Errata/Grade--Breast: Are the codes on page 94 of the SEER manual's Breast Grading Conversion Table requiring conversion of nuclear grades 1/3 and 1/2 to code 1, 2/3 to code 2, and 2/2 and 3/3 to code 3 correct or are the codes on page C-473 in the Three-Grade System (Nuclear Grade) for breast correct that requires conversion of the same examples to codes 2, 3, and 4 respectively?
On page C-473: Delete the section titled "Three-Grade System (Nuclear Grade)" and delete the table. Use the tables on pages 94 and C-472 to code grade for breast cancer. This correction will be made in the next errata.
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.
Multiplicity Counter: Are in situ tumors diagnosed more than 60 days after invasive tumors of the same site and histology included in the Multiplicity Counter?
If an in situ tumor following an invasive tumor is a single primary according to the multiple primary rules for that particular site, include the in situ and the invasive tumors in the multiplicity counter.
Multiple Primaries (Pre-2007)--Kidney/Bladder/Renal Pelvis: Would transitional cell carcinoma of the left renal pelvis, diagnosed two years after a diagnosis of invasive bladder cancer, be a second primary when the discharge is "recurrent transitional cell carcinoma, left kidney"?
For tumors diagnosed prior to 2007:
This is an example of the term "recurrent" being used loosely to refer to another primary in the urinary tract. It is highly unlikely that a bladder tumor would metastasize to the kidney. Much more likely is the field defect or regional breakdown of the urothelial tissue that lines the tract from the renal pelvis to the urethra. Furthermore, bladder tumors don't spread retrograde to the kidney. Code as two primaries.
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.
1) If Van Nuys nuclear grade 2 is the only grade given for an in situ breast primary, would it be coded as a 3-component system (e.g., 2/3 = 3)?
2) Is there a way of determining grade if only the total Van Nuys Prognostic index score is given (e.g., score 7/9)?
1. Code Van Nuys grade 2 as code 2 [Grade 2] in the Grade, Differentiation field.
2. Code Van Nuys score of 7 as 9 [Cell type not determined, not stated or not applicable] in the Grade, Differentiation field.
Currently, there is no conversion from the total Van Nuys score to grade because "grade" represents only one of the three Van Nuys factors that make up the total score. The other factors are tumor size and margin. The grade represents from 1 to 3 points within the total Van Nuys score. The total score can be between 3 and 9.
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