| Report | Question ID | Question | Discussion | Answer | Year |
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20000514 | Histology (Pre-2007)--Skin: Are "atypical melanocytic hyperplasia" and "severe melanotic dysplasia" synonyms for melanoma in situ? |
For tumors diagnosed prior to 2007: No. SEER determines its reportable list from the ICD-O-3. The above terms are listed as tumor-like lesions and conditions, but are not in situ or malignant. 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. |
2000 | |
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20000272 | Grade, Differentiation: Are anaplastic tumors always coded to grade 4, even for anaplastic brain primaries? | Yes. Always code the Grade, Differentiation field to for 4 [Grade IV] for "anaplastic" tumors. Anaplastic is synonymous with undifferentiated. Refer to the example in the SEER Program Code Manual, 3rd Ed. | 2000 | |
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20000478 | Multiple Primaries (Pre-2007)--Breast: When a breast cancer is treated with less than a total mastectomy and more than 2 months later a tumor of the same histology is diagnosed in the same breast with no statement of "recurrence," is this a new primary? | For tumors diagnosed prior to 2007:
Count as 2 primaries when a subsequent malignant breast tumor is diagnosed more than 2 months later unless stated to be a recurrence. For cases diagnosed after 1/1/94, an in situ followed by an invasive breast cancer is counted as two primaries even if stated to be a recurrence.
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. |
2000 | |
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20000495 | EOD Fields--All Sites: Is EOD information limited to what is available exactly two months from the day of diagnosis? | For cases diagnosed 1998-2003:
EOD should include all information available within four months of diagnosis in the absence of disease progression or through completion of surgery(ies) in first course of treatment, whichever is longer.
Mets known to have developed after EOD was established should be excluded. |
2000 | |
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20000243 | Surgery of Primary Site--Lung: What code is used to represent "photodynamic therapy" (PDT) for lung primaries? See Discussion. | PDT is not listed in the Surgery to Primary Site field codes for lung. | For cases diagnosed 2003 and later, code the Surgery of Primary Site field to 19 [Local destruction or excision, NOS] for lung primaries. Photodynamic therapy is a surgical procedure that results in the local destruction of tumor. | 2000 |
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20000280 | Primary Site--Breast: Is there a hierarchy for coding subsite for breast cases when there is conflicting information in the physical exam, mammogram, operative and pathology reports as to the exact location of the primary? See discussion. | Example: Two mammograms were performed. One report indicates the lesion is at 12:00 and the other indicates it is in the upper central quadrant. However, the pathology report from the modified radical mastectomy specimen indicates the mass is in the UIQ.
According to one of our physicians, when a pathologist has a mastectomy specimen with attached axillary contents, the location of the lesion (subsite) is very accurate. |
Code the Primary Site field to C50.2 [upper inner quadrant]. In general, the priority for using information is pathologic, operative, and clinical findings. The pathology report would take precedence in this case. The 2004 SEER Program Code manual will include the following instructions for determining breast subsite. Priority Order for Coding Subsites Use the information from reports in the following priority order to code a subsite when the medical record contains conflicting information: 1 Pathology report 2 Operative report 3 Physical examination 4 Mammogram, ultrasound If the pathology proves invasive tumor in one subsite and insitu tumor in all other involved subsites, code to the subsite involved with invasive tumor. |
2000 |
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20000242 | EOD-Size of Primary Tumor--Prostate: Should the size of tumor be recorded as 001 (focus) or the actual size when both are stated? See Discussion. | The pathology report from a TURP identifies a 3-mm focus of adenocarcinoma. | For cases diagnosed 1998-2003, code the EOD-Size of Primary Tumor field to 003 [3 mm]. The rule that says to code a focus or foci of tumor as 001 was developed for use when no tumor size is given. | 2000 |
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20000270 | EOD-Lymph Nodes--Lung: What code is used to represent this field when the only information is a description of: 1. "hilar mass" 2. "mediastinal mass" 3. "enlarged" or "greater than 1 cm" used to describe any of the lymph nodes listed under code 2 in the EOD Lymph Nodes field? |
For cases diagnosed 1998-2003:
Code EOD-Lymph Nodes fields as follows for the examples given:
1) 9 [Unknown; not stated] for a "hilar mass" 2) 2 [Mediastinal] for a "mediastinal mass" 3) 2 [Mediastinal] for "enlarged" or "greater than 1 cm," if used to describe any of the named lymph nodes listed under code 2 in the EOD-Lymph Nodes field. |
2000 | |
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20000247 | EOD-Pathologic Extension--Prostate: If there is residual tumor in the distal urethra on prostatectomy, does that mean there is distal urethral margin involvement? See discussion. | 2/98 Prostate bx: Right apex, right mid and right base positive for adenocarcinoma. 6/1/98 Radical retropubic prostatectomy w/ bilateral pelvic lymph node dissection. Pathology: Residual adenocarcinoma in distal urethra, right lateral sections and posterior lobe. Right apical margin, other margins, seminal vesicles, and 7 pelvic LN negative for malignancy. |
For cases diagnosed 1998-2003: For the example above, code the EOD-Pathologic Extension field to 34 [extending to apex] because most of the right side is involved. The pathology report says all margins are free. The comment on residual tumor in the urethra, meant the first surgery did not completely remove tumor tissue from the urethra, it does not mean that tissue is at the margin. |
2000 |
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20000554 | EOD-Extension--Stomach: What code is used to represent this field for a stomach primary described as linitis plastica? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 30 [Localized, NOS], unless more information is known about the extent of tumor involvement. Coding the Histology field to 8142/3 [Linitis plastica] and the Size of Primary Tumor field to 998 [Diffuse; widespread; 3/4 or more: Linitis plastica] identifies this diagnosis.
In the EOD-Extension field, the depth of invasion is the important characteristic to be coded. The 10 digit EOD corresponds to the AJCC Staging Manual in which the "T" is based on level of invasion. While a diagnosis of linitis plastica indicates a worse prognosis, it does not define the extent of infiltration. There is no luminal mass with linitis plastica. Instead, the entire gastric wall is thickened by tumor. |
2000 |
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