System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 02/15/2026 02:41 AM

Report Question ID Question Discussion Answer Year
20150022

Grade--Bladder: Do you use the grade stated on the pathology report for coding the grade/differentiation field for bladder and renal pelvis field? See discussion.

Please confirm correct coding for grade for papillary urothelial carcinoma of the bladder/renal pelvis and urothelial carcinoma of the bladder/renal pelvis. SEER Manual 2014 and 2015 state: "Do not use these tables to code grade for any other groups including WHO (CNS tumors), WHO/ISUP (bladder, renal pelvis), or FIGO (female gynecologic sites) grades." They also state "In transitional cell carcinoma for bladder, the terminology high grade TCC and low grade TCC are coded in the two-grade system" in the Grade section. These statements are not included in SEER Manuals prior to 2014.

Use the grade stated on the pathology report to code grade/differentiation for bladder and renal pelvis field unless the grade is stated to be WHO/ISUP grade.

2015
20150064

Primary site--Head & Neck: When there is invasive in one subsite and in situ in another, do you code the subsite with the invasive only? Would the correct site be C320, C328, or C329? See discussion.

LARYNGOSCOPY - ENDOLARYNGEAL EXAM WAS GROSSLY UNREMARKABLE EXCEPT THAT SHE APPEARS TO HAVE A T1A SQUAMOUS CELL CARCINOMA OF THE RIGHT TRUE VOCAL FOLD. IT EXTENDS FROM ALMOST THE ANTERIOR COMMISSURE ALL THE WAY BACK TO THE VOCAL PROCESS AND IS EXOPHYTIC IN NATURE. IT DOES NOT EXTEND INTO THE VENTRICLE OR ONTO THE FALSE VOCAL FOLD. NO SUBGLOTTIC EXTENSION IS SEEN. A. RIGHT POSTERIOR FALSE VOCAL CORD FOLD, BIOPSY:  SQUAMOUS CELL CARCINOMA IN SITU. B. RIGHT POSTERIOR TRUE VOCAL CORD FOLD, BIOPSY:  SQUAMOUS CELL CARCINOMA, SUSPICIOUS FOR INVASION. C. RIGHT MID TRUE VOCAL CORD, BIOPSY:  SQUAMOUS CELL CARCINOMA, SUSPICIOUS FOR INVASION. D. RIGHT ANTERIOR TRUE VOCAL FOLD, BIOPSY:  INVASIVE AND IN SITU SQUAMOUS CELL CARCINOMA, MODERATELY DIFFERENTIATED.

See the Head & Neck Terms and Definitions for guidance on coding the primary site, pages 17-18, http://seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf

Based on the information provided, use the statement from the endoscopy report and assign primary site to right true vocal fold [cord], C320.

2015
20160065

MP/H Rules/Histology--Lung: What histology code and MP/H Rule applies to the Histologic Type described as adenocarcinoma, mixed invasive mucinous and non-mucinous which involves multiple lung tumors present in a single lobe? See Discussion.

The patient had a lower lobectomy with final diagnosis of adenocarcinoma with the following features: Tumor Focality: Multiple separate tumor nodules in same lobe; Tumor Size: 2.6 cm, 0.7 cm, 0.3 cm and 0.1 cm in greatest dimension; Histologic Type: Adenocarcinoma, mixed invasive mucinous and non-mucinous adenocarcinoma; Histologic Grade: Moderately differentiated.

Assign histology code 8254/3.

The 2007 MP/H Lung rules do not include coding guidelines for mixed mucinous and non-mucinous tumors. Lung Table 1 (in the Terms and Definitions, pages 37-38, http://seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf ) is very specific about which histologies can be coded to mixed adenocarcinoma (8255/3). Mucinous is not included per the note at the end of Table 1. Per WHO 3rd and 4th Ed Tumors of the Lung, mixed mucinous and non-mucinous tumors of the lung are classified as 8254/3.  Mixed invasive mucinous and non-mucinous adenocarcinoma is a synonym for BAC, mucinous and non-mucinous.

2016
20160045

Neoadjuvant treatment/Grade--Prostate: How should the grade/differentiation field be coded when hormone therapy is given prior to radiation for metastatic prostate cancer? Is hormone treatment "neoadjuvant treatment" in this situation? Per NCCN guidelines, neoadjuvant hormone therapy is strongly discouraged outside of a clinical trial for localized disease. However for metastatic disease, hormone is recommended (gold standard). See discussion.

8/1/15 CT Exam showed enlarged prostate and left seminal vesicle with multiple enlarged pelvic LNs. Findings: suspicious for prostate cancer with invasion of seminal vesicle. Bone scan findings: positive bone mets in multiple sites. PSA 169.0 (elevated). Patient was started on casodex 8/12/15. A prostate biopsy was performed on 9/16/15 to confirm diagnosis, adenocarcinoma Gleason 4+5. Patient's treatment continued with radiation to bone.

For cases diagnosed prior to 2018

Code the grade/differentiation field from the biopsy for this situation. According to experts consulted, hormone therapy does not alter the grade in this case and grade should be coded based on information after hormone therapy when that is the only grade information available.

 2016
20160060

Mets at diagnosis fields--Heme & Lymphoid Neoplasms (Lymphoma): How are Mets at Diagnosis -- Bone, Brain, Liver, Lung, Lymph Node, and Other -- to be coded for lymphomas in 2016? Are they always 0 if the TNM Stage is I, II, or III? How is bone marrow involvement coded -- in which Mets at Diagnosis field?

Note: Answer verified Sept. 2019, still valid for current cases.

Code all mets at diagnosis fields to 0 when the Stage is I, II, or III.

When the lymphoma is Stage IV, one of the mets at dx fields (other than Mets at Dx-Distant lymph nodes) needs to be coded to 1. Stage IV indicates that there is multiple extralymphatic organ involvement, diffuse involvement of an organ; liver, brain, lung or bone involvement, or bone marrow involvement.

For bone, brain, liver, and lung, code these as 1 when these sites are involved and they are not the primary site. This is the same instruction for solid tumor neoplasms.

For mets at dx-distant lymph nodes, always code to 0. For lymphomas, lymph node involvement is included in stage and not based on whether they are regional or distant.

For mets at dx-other, code to 1 for bone marrow involvement or if there is multi extralymphatic organ involvement.

 2016
20160016

MP/H Rules/Histology--Bladder: Can the histology for a high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" be coded to sarcomatoid transitional cell carcinoma (8122/3)?

Example; TURBT, Final Diagnosis - Urothelial carcinoma, high grade. Type/grade comment: Extensive sarcomatoid dedifferentiation is present (40-50% of tumor volume).

Code high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" to sarcomatoid transitional cell carcinoma (8122/3).

2016
20160028

MP/H/Histology--Sarcoma:  How should Ewing Sarcoma/primitive neuroectodermal tumor (PNET) be coded for a 2012 case?  See Discussion.

SEER SINQ 20031051 applies to cases diagnosed before 2007 and advises:  Code histology as 9260/3, Ewing sarcoma. Ewing sarcoma is a specific histology on the continuum of primitive neuroectodermal tumors. Code Ewing sarcoma as it is more specific than PNET, NOS.

For tumors diagnosed 2007 or later, refer to the MP/H rules.

Apply 2007 MP/H rule H6 and assign the numerically higher ICD-O-3 code that reflects PNET (9364/3).

According to the WHO Tumors of Soft Tissue and Bone, though Ewing sarcoma ICD-O-3 code is 9260/3, Ewing sarcoma with a higher degree of neuroectodermal differentiation present is classically termed peripheral neuroectodermal tumors (PNET).  WHO does not offer guidance how to classify tumors stated to be Ewing sarcoma PNET.

Histology code 9364/3 is assigned for a Ewing/PNET that arises outside of the brain/CNS. Peripheral neuroectodermal tumor (PNET) and peripheral primitive neuroectodermal tumor (PPNET) are Ewing family tumors.

Histology code 9473/3 (PNET, primitive neuroectodermal tumor, central primitive neuroectodermal tumor, or supratentorial PNET) is only used for tumors arising inside the brain/CNS.

2016
20160050

Reportability--Appendix: Is a mucinous cystic neoplasm with high grade dysplasia of the appendix reportable? See discussion.

The language appears similar to the mucinous cystic neoplasm of the pancreas with high grade dysplasia (8470/2), which was clarified to be reportable in 2014.

WHO does not list MCN as a histology for the appendix. This case should be clarified with the pathologist.

For pancreas specifically, the term "mucinous cystic neoplasm (MCN) with high grade dysplasia" replaced the term "mucinous cystadenocarcinoma, noninvasive" according to WHO. MCN with high grade dysplasia of the pancreas is reportable because it is used in place of the now obsolete terminology. If we did not make the new terminology reportable, trends over time could be affected.

 

2016
20160047

Reportability--Eye: Is conjunctival intraepithelial neoplasia (CIN III) from an excision of the left eye conjunctiva reportable?

Conjuctival intraepithelial neoplasia grade III (CIN III) is reportable. Intraepithelial neoplasia, grade III, is listed in ICD-O-3 as /2. It is reportable for sites other than skin.

2016
20160054

MP/H Rules/Multiple primaries--Melanoma: How many melanoma primaries should be abstracted if, during the workup for a metastatic melanoma of an unknown cutaneous site, an in situ melanoma is also discovered? See Discussion.

Patient has diagnosis of melanoma with spindle cell features found in a right lower lobectomy specimen. Chart notes indicate this is metastatic from a cutaneous primary of unknown site. Further work up includes a biopsy of the tip of the nose, which is diagnostic for in situ melanoma. Should this be abstracted as two separate primaries, one for an invasive melanoma of unknown primary site and the other for an in situ melanoma of the skin on the tip of the nose? Which MP/H Rule would apply?

Yes, abstract this as two separate primaries, an invasive melanoma of unknown primary site and an in situ melanoma of the skin on the tip of the nose. Rule M3 applies.

2016