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For tumors diagnosed prior to 2007:

Yes. This is one primary and should be coded to C49.5 [Connective, subcutaneous and other soft tissue of pelvis]. According to Rule A in ICD-O-3, the type of tumor ("sarcoma") indicates origin from a particular tissue, resulting in the primary site code of C49.5 [Inguinal region, NOS] for this sarcoma.

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.

For tumors diagnosed prior to 2007:

Code the Histology field to 8830/3 [Malignant fibrous histiocytoma]. Code the Date of Diagnosis to October 1999 based on the clinician's statement of "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." Assume that this statement means that the physician re-evaluated the clinical course and decided that the original tumor must have been malignant.

If the original slides are reviewed and the diagnosis is changed to a malignancy or if the clinician states that the first occurrence was obviously malignant, backdate the date of diagnosis to the first occurrence.

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.

Yes, those modalities should be counted as part of first course of cancer-directed treatment if the patient continues with the planned first course. For example, if patient has the originally planned type of surgery, radiation, or drug protocol, then code the given treatment as first course.

Caution: It is not a change in the treatment plan if the drugs are changed but the action of the drugs remains the same. This is still first course. However, if the treatment is changed from a chemotherapy drug to a hormonal drug following the discovery of the mets, do not code the hormonal therapy as first course.

For cases diagnosed 1998-2003:

In coding the EOD-Extension field, ignore metastasis that is discovered after the initial workup is completed regardless of the timeframe from diagnosis date until the date the metastatic deposit was discovered. The metastasis is progression of disease.

Any of the following represents progression of disease. Do not code the subsequently identified metastatic involvement in the EOD:

1) The metastatic workup was complete and treatment started before the procedure was done that found the metastatic involvement.

2) A procedure, such as a scan, was negative initially and a repeat of that procedure is now positive.

3) The treatment plan is developed for a localized disease process.

If you are unable to determine whether the newly discovered metastasis represents progression or is part of the initial workup, regard the metastasis as progression. Do not code the metastasis in the EOD-Extension field.

For cases diagnosed 1998-2003:

Do not include the spinal metastasis because it was diagnosed after the extent of disease was established. If metastasis was not present at diagnosis, and not discovered during the original metastatic work-up, it is progression of disease.

For cases diagnosed 1998-2003: Code the EOD-Extension field to 85 [metastasis]. Bone metastasis was documented during the original metastatic workup. Metastasis to the bone was suspected soon after diagnosis and confirmed prior to the start of treatment. The length of time between the diagnosis and the confirmation of the bone metastasis was not used to code extension on this case. The pt was still being worked up as evidenced by the fact that treatment had not yet started.

For cases diagnosed prior to 1/1/2010:

Code the Histology field to 9989/3 [myelodysplastic syndrome] and the Date of Diagnosis field to June 2001.

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.

For tumors diagnosed prior to 2007:

Code the Histology field to 8507/3 [micropapillary carcinoma]. According to rule H, the topography code listed in the ICD-O is disregarded if the tumor is known to arise in another site. In this case, the site is thyroid [C73.9] so the topography code of breast [C50._] can be disregarded for this histology. Apply the matrix principle to change the Behavior Code from 2 to 3.

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.

For cases diagnosed 1998-2003:

Code EOD extension as 30 [Localized, NOS] and laterality as 4 [Bilateral involvement]. The next update to the SEER edits will allow this combination.

For tumors diagnosed prior to 2007:

Code the Histology field to 9081/3 [Teratocarcinoma, mixed embryonal carcinoma and teratoma], in both ICD-O-2 and ICD-O-3.

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.