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Report Produced: 05/07/2026 09:40 AM

Report Question ID Question Discussion Answer Year
20021185 Surgery of Primary Site--Major salivary gland: How do you code Surgery of Primary Site for a submandibular gland primary when the operative report refers only to an excision of the submandibular "tumor" while the pathology report states the submandibular "gland" was removed? See discussion. The gross description on the pathology report indicates that the specimen consists of a "submandibular gland." A further description on the pathology report included, "the specimen was sectioned exposing a focally cystic mass that nearly replaces the entire specimen." For cases diagnosed on 1/1/2003 or after: Code the Surgery of Primary Site field to 40 [Total parotidectomy, NOS; total removal of major salivary gland, NOS], per the pathology report's gross description of the specimen unless the operative report description of procedure indicates that the removal was less than total. 2002
20021005 EOD-Extension--Lymphoma: What code is used to represent this field for an extranodal lymphoma that has more than one tumor in the primary site OR has intraluminal extension from the primary site to an adjacent organ? See discussion.

1. Small lymphocytic lymphoma with 2 tumors in the stomach.

2. Lymphoma involving the cecum and ileum.

3. Lymphoma of the fundus of stomach with extension into the esophagus.

For cases diagnosed 1998-2003:

Using the EOD scheme for lymphoma, code the Extension field to 11 [Localized involvement of a single extralymphatic organ or site; Stage IE] for all 3 of these cases.

For the stomach lymphoma: There are 2 areas of lymphoma, but it is still confined to one site.

For the other 2 lymphomas: Intraluminal (mucosal) spread of the lymphoma never equals extension. The same phrase that was added to code 21, "Direct extension to adjacent organs or tissues", will be added to code 11 in the Collaborative Stage System. Neither "mucosal spread to a contiguous organ" or "direct extension into a nearby organ" affect staging. Both are still coded to 11 as long as there are no other sites of lymphoma involvement.

EOD code 80 is poorly written. It does not mean diffuse invovement or multiple tumors in a single organ but rather "diffuse disease in two or more organs."

 2002
20020058

Multiple Primaries/Histology (Pre-2007)--Colon: Would one primary be reported when adenocarcinoma arising in a polyp NOS [8210/3] and adenocarcinoma arising in a tubulovillous adenoma [8263/3] were simultaneously diagnosed in the sigmoid colon (first 3-digits of the histology are different)?

For tumors diagnosed prior to 2007:

Code as one primary. Code the Histology field to 8263/3 [Adenocarcinoma in tubulovillous adenoma].

Count as a single primary and code the more specific term when simultaneous lesions are present and one lesion is an "NOS" term and the other is a more specific term. "Polyp" is an NOS term. Adenoma is an associated term, but is more specific (Tubulovillous adenoma is more specific than "polyp").

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.

 2002
20021103 Surgery of Primary Site/First Course Treatment--Liver: If disease progression is so rapid that the initial therapy plan is changed before patient receives any therapy, would "no therapy" be the first course? See discussion. Patient was diagnosed with liver cancer on 8/23 and on 9/6 a hepatectomy was recommended. However, patient was hospitalized on 9/19 with ascites. Patient underwent embolization instead of a hepatectomy during that admission.

Code the "embolization" (or hepatic artery embolization, HAE) in Surgery of Primary Site. Assign code 10 [local tumor destruction, NOS].

The embolization is coded as first course of therapy for this case because it seems that this patient was not adequately staged until 9/19 -- there is no indication on this case of the stage of disease in August or early September. Furthermore, no treatment was started before the embolization. Therefore, the ascites is not "progression of disease" in this case -- it is taken into account as part of the initial stage of disease.

This procedure was previously coded as other therapy, experimental. Code as surgery as of July 2005.

 2002
20021089 Primary Site--Ovary/Peritoneum: When ovaries are not found on a resection or if the ovaries removed are negative for malignancy, but the clinician refers to the adenocarcinoma in the pelvis as being an "ovarian" primary, should the primary site be coded as ovary, pelvic peritoneum or unknown? See discussion.

Example 1: Patient has a history of a BSO without an indication that it was done for malignancy. Pt has a resection. No ovarian tissue found. No site is mentioned in the pathology report. The clinician refers to the diagnosis of adenocarcinoma in the pelvis as an "ovarian" primary.

Example 2: Resected ovaries are negative. No specific site of origin is mentioned in the path. Again, the clinician refers to the diagnosis of adenocarcinoma in the pelvis as an "ovarian" primary.

 Code the Primary Site for both examples to peritoneum [C48.2]. When the physician refers to a case as "ovarian" even though the ovaries are negative or when the histology is an ovarian histology, such as papillary serous ca, the primary site should be coded to the peritoneum. Code the Primary Site to where it appears the disease is arising. 2002
20021060 EOD-Size of Primary Tumor: The EOD Manual instructs us not to code the size of a cyst. Can we code the size of tumor lesions described as being multicystic, multiloculated, or as a complex mass with cystic areas? See discussion.

Example 1: Large multicystic ovarian mass lesion measuring 10 cm. Sections through the specimen show a multicystic and solid mass with abundant fluid exuding from the cut surfaces (Size of the solid portions is not stated).

Example 2: A brain MRI: 9-cm. complex mass with cystic areas.

For cases diagnosed 1998-2003:

Yes, if the cystic mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field based on the size of the mass in the absence of a more precise tumor size description. For the examples in the discussion section, code the EOD-Size of Primary Tumor field to: 1) 100 [10 cm]. 2) 090 [9 cm].

As a point of interest, the size of tumor for ovarian and brain primaries is not used in either analysis or as a prognostic indicator for survival. Therefore, spending time separating the cystic and solid portions of the tumor is unnecessary.

 2002
20021153 Grade, Differentiation--Breast: Is "histological grade" another way of saying "tubule formation" which would result in the following case having a Bloom-Richardson (BR) score of 7 which would be coded to grade 2? See discussion. Final path diagnosis stated: Invasive ductal ca, histological grade 3/3, nuclear grade 2/3, mitotic index-moderate. Yes. Code the Grade, Differentiation field to 2 [Grade 2] for this case. This case has a BR score of 7 which converts to a grade of 2. This pathologist seems to be describing the three parts of the BR system: tubule formation, mitotic activity and nuclear grade. 2002
20021014 Reportability: Is "Castleman's Disease" reportable?

For cases diagnosed prior to 1/1/2010:Castleman's Disease is not reportable to SEER. Synonyms for this disease process include: Castleman-Iverson Disease, benign giant lymph node hyperplasia, and angiofollicular mediastinal lymph node hyperplasia. Castleman's Disease is a rare disorder characterized by non-cancerous growths that may develop in the lymph node tissue throughout the body. The plasmacellular form of this disease may progress to lymphoma or plasmacytoma.

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.

 2002
20020063 EOD-Extension--Breast: How do we interpret "dermal lymphovascular space invasion" and "dermal lymphovascular invasion" for extension? See discussion. A breast path report states tumor invades dermal lymphovascular spaces. Also, pathologists sometimes state "dermal lymphovascular invasion". Are both these terms synonymous with dermal lymphatic invasion?

For cases diagnosed 1998-2003:

Dermal lymphovascular invasion and tumor in dermal lymphatics would both be coded as dermal lymphatic invasion.

 2002
20021055 EOD-Extension--Liver: Can we use CT scan descriptions such as "portal vein thrombosis" or "extensive infiltration of the liver" or "diffuse infiltration of the liver" to code extension for liver primaries? See discussion.

1. Would you code portal vein involvement for a CT scan description of "portal vein thrombosis"?

2. Would you code more than one lobe of the liver as involved for CT scan descriptions of "extensive infiltration of the liver" or "diffuse infiltration of the liver"?

For cases diagnosed 1998-2003:

1. No. Thrombosis can be caused by non-cancerous conditions.

2. Yes. Code the EOD-Extension field to 65 [Multiple (satellite) nodules in more than one lobe of the liver] when "extensive infiltration" or "diffuse infiltration" is stated.

 2002