Report | Question ID | Question | Discussion | Answer | Year |
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20091037 | MP/H Rules/Histology--Brain: How is histology coded for a "low grade neuroglial tumor" of the fourth ventricle? | For cases diagnosed 2007 or later, assign histology code 9505/1 [Ganglioglioma, NOS].
According to our pathologist consultant, low grade neuroglial tumor of the fourth ventricle correlates best to the "rosette-forming glioneuronal tumor of the 4th ventricle" which is a new WHO entity. There is no current ICD-O-3 code for this. The best code available at this time is 9505/1. |
2009 | |
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20091036 | CS Mets at DX/CS Extension--Ovary: Is carcinomatosis always captured in the CS Mets field? Can the term carcinomatosis be used to describe peritoneal implants as well? See Discussion. | 1/18/06 CT guided biopsy of abdominal mass & ant peritoneum nodule: Extensive carcinomatosis affecting the paracolic gutters, liver surface & pelvis. 6 cm tumor mass was visibly engulfing the small bowel & tube; poorly differentiated adenoca, mullerian derived, shows attributes of clear cell carcinoma, high grade (FIGO III), 2.5 cm size, does not involve fallopian tube. R&L abdominal wall & mesentery, mets adenoca. 5/31/06: tumor debulking with right salpingo-oophorectomy. Final DX: Poorly differentiated adenocarcinoma, clear cell type, right ovary (FIGO III), stage IV per MD. |
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.In the case of ovarian cancer, the term carcinomatosis may refer to peritoneal implants, especially when the implants are numerous. It does not refer to distant metastases in this context. This issue has been forwarded to the CS version 2 committee. |
2009 |
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20091035 | CS Extension--Ovary: What code is used to capture omental caking? | 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.The term "omental caking" refers to a thickened omentum. In the case of ovarian cancer, omental caking is always indicative of involvement of the omentum. The omentum is an abdominal structure for the purposes of CS extension. Assign the appropriate code between 70-73.
When the size of implants is not stated, but operative report and scans state omental caking, code 71 would be best. When there are no size measurements on the operative report or scan or elsewhere, there is not enough information to assign 72. The choice of code between 70 and 73 will depend on the details of the specific case. |
2009 | |
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20091034 | CS Extension--Ovary: How are the following terms coded when they are described in the medical record without any other qualifying information? Seeding, talcum powder appearance, salting, miliary, and studding. | 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.Seeding, talcum powder appearance, salting and studding are synonymous with implants. When the size of implants is not stated, but operative report and scans state "seeding," "talcum powder appearance," "salting," and "studding" the CS extension code choice will depend on the location of the seeding, talcum powder appearance, salting, or studding.
The word "miliary" is not documented as a synonym for implants. The term miliary does not affect the CS extension code choice according to the current CS instructions. |
2009 | |
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20091033 | CS Tumor Size--Ovary: Can the size of a tumor mass shadow seen on a CT scan be used to code CS Tumor Size? See Discussion. | Ovarian primary: No surgery performed. CT abd/pelvis states "Bilateral pleural effusions, ascites. Right appendix region with tumor mass shadow 3 x 8 x 3.9cm" | 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 CS tumor size 999 [Unknown; size not stated]. The size of the tumor is not known in this case. Note that tumor size is not used for AJCC staging for ovary. |
2009 |
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20091032 | Surgery of Primary Site--Ovary: How should this field be coded for an ovarian primary when there is a BSO and only the fundus of uterus is removed (not a full hysterectomy)? | Assign surgery code 52 [Bilateral (salpingo-) oophorectomy; WITH hysterectomy]. Code 52 does not exclude a partial hysterectomy. | 2009 | |
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20091031 | MP/H Rules/Histology--Thyroid: How is histology coded for a thyroid tumor described as "predominantly papillary carcinoma, tall cell variant, follicular type"? | For cases diagnosed 2007 or later, assign code 8340 [Papillary carcinoma, follicular variant] according to rule H15 for Other Sites. "Predominantly" and "type" indicate specific histologies. "Variant" does not. See rule H13. The histology in this case is papillary and follicular. Tall cell variant is ignored. |
2009 | |
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20091030 | MP/H Rules/Multiple Primaries--Thyroid: How many primaries should be coded if there is a clinical diagnosis of recurrent thyroid carcinoma in 3/08 in a patient with a history of thyroid carcinoma diagnosed in 1995 with a 2002 clinical recurrence? See Discussion. | Thyroid carcinoma diagnosed in 11/95 and treated with total thyroidectomy (although path report only mentions the left lobe) and ablation. Elevated thyroglobulin level in 11/02, stated to have recurrent carcinoma and again treated with ablation. History on this case states patient had a near total thyroidectomy at diagnosis. Patient is seen again at a third hospital 3/08. Diagnosis again is recurrent carcinoma apparently because of a thyroid mass that is palpable. No treatment was performed and patient expired 4/08. Is this a new primary because of MP/H rule M10? | For cases diagnosed 2007 or later: The pathology report takes precedence over the other information when there is a discrepancy. Based on the information available, only the left thyroid lobe was removed 11/95.
Use the 2007 MP/H rules to evaluate new tumors. If the 3/08 diagnosis represents a new tumor, use the MP/H rules. If the diagnosis in 3/08 is not new tumor, the MP/H rules do not apply.
For this case, a new tumor in 3/08 would be a new primary using rule M10 for Other Sites. |
2009 |
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20091029 | MP/H Rules/Histology--Melanoma: How should histology be coded for a melanoma arising in a compound nevus, NOS or a nevus, NOS? | For cases diagnosed 2007 or later, assign code 8720 [Melanoma, NOS] to melanoma arising in a nevus that does not have a specific code or to melanoma arising in a nevus, NOS. Currently, ICD-O-3 does not have a specific classification for a melanoma arising in a compound nevus. |
2009 | |
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20091028 | MP/H Rules/Multiple primaries/Cancer-directed treatment--Lung: Is a 2008 occurrence of non-small cell carcinoma in the left lower lobe following a 1998 occurrence of the same histology in the left lung to be counted as a new primary if the 1998 primary was treated with chemotherapy and/or radiation but not surgery? See Discussion. |
1998 diagnosis on non-small cell carcinoma treated with radiation and chemotherapy. In 2008, there is an abnormality in the LLL with brushings/washings positive for non-small cell carcinoma. According to the MP/H rules, M8 states this would be a new primary. However, in the document titled " Quality Improvement Meeting August 2008," found on the SEER website, it stated that because the patient never had surgery for the initial primary there is no evidence that the patient was ever disease free. Therefore, the occurrence of the latter tumor would not be a new primary (p. 7, "colon"). Does this answer pertain only to surgery or does it apply to any type of treatment? |
For cases diagnosed 2007 or later, the 2007 MP/H rules apply if the 2008 diagnosis is a new tumor. Was there any statement that the patient was free of disease (NED) after the chemo and radiation therapy? (A patient can be disease free without surgery). If there is no statement to the contrary, no mention of metastasis from the 1998 diagnosis, and no mention of disease between 1998 and 2008, follow lung rule M8 and abstract the 2008 diagnosis as a new primary. This lung case differs from the colon case discussed in the document titled "Quality Improvement Meeting August 2008." For the colon case, there was disease in 2003, 2005 and 2007. Based on the information provided, the 2007 diagnosis was not a new tumor because the patient was never free of disease. Therefore, the 2007 diagnosis is not a new primary. The number of reportable primaries was based on disease status over time, and was not based on the type of treatment given for the initial tumor (i.e., surgery or any other treatment modality). |
2009 |