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| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20220011 | Reportability/Ambiguous Terminology: When the only source of information states the diagnosis as two terms, one reportable and one non-reportable, separated by a "slash" (/), should we report the case using the reportable term? See Discussion. |
For example: -ultrasound of the right eye: consistent with a nevoma/melanoma; we could not find any indication that nevoma is a reportable term -bladder biopsy pathology report: severe urothelial dysplasia/carcinoma in situ (CIS) As a central registry, we receive some limited information cases like this where there is no record of treatment or possibility to follow-back to physicians for clarification, so we want to make sure we are reporting them correctly. |
If possible, try to obtain further information. If no further information can be obtained, accession the case using the reportable term, melanoma and CIS in the respective examples, when there is a single report in which both reportable and non-reportable diagnostic terms are listed with a slash and there is no other information. Most often, the slash indicates the terms are being used synonymously. |
N/A | N/A | 2022 |
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20220001 | Solid Tumor Rules (2022)/Histology--Bladder: Can the term configuration be used to code the more specific histology for bladder primaries diagnosed 2022 and later? See Discussion. |
In the September 2021 Urinary Sites Solid Tumor Rules update, the term configuration was removed from the “DO NOT CODE histology when described as” list. However, it was not added as a term that can be used to code the more specific histology for urinary tumors. Can configuration be used to code the more specific histology 8130 (papillary urothelial carcinoma) when the diagnosis is urothelial carcinoma, tumor configuration: papillary? |
Beginning with cases diagnosed 1/1/2022, the term "configuration" can be used to code histology for urinary sites only. At the request of the AJCC urinary experts, the instructions were changed to allow configuration to be used to code histology. |
Bladder | Histology | 2022 |
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20220012 | EOD 2018/Regional Nodes--Corpus Uteri: Are lymph nodes found on imaging post-surgery included in Extent of Disease (EOD) Regional Nodes if surgery is already completed? See Discussion. |
11/16/20: Patient diagnosed with endometrial cancer on by MRI of the pelvis; 11.5 cm uterine mass consistent with cancer with no lymphadenopathy. 1/6/21: Patient had a total abdominal hysterectomy/bilateral salpingo-oophorectomy and pelvic lymph node dissection. Operative report stated patient had mildly enlarged bilateral pelvic nodes. Path report: Endometrioid adenocarcinoma with invasion of the serosa. Five bilateral pelvic nodes were sampled and negative. Originally, staging had patient as node negative. 1/22/21: Patient had post op imaging done that showed metastatic retroperitoneal, aortocaval, and possibly left iliac lymph nodes. Physician changed staging to include the lymph node involvement. |
EOD includes all information available within four months of diagnosis in the absence of disease progression or upon completion of surgery(ies) in first course of treatment, whichever is longer. Since the imaging was within the four-month window, and the nodes could have been positive during surgery but not assessed by the surgeon, use the information from the imaging. Assign code 600 for EOD Regional Nodes for involvement of the aortocaval and retroperitoneal nodes (para-aortic nodes), size unknown. |
Corpus uteri | EOD Regional Nodes | 2022 |
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20220026 | Solid Tumor Rules/Histology--Parotid: How is histology coded for a myoepithelial carcinoma ex-pleomorphic adenoma of the parotid? |
Patient has a 2021 left parotidectomy showing myoepithelial carcinoma ex-pleomorphic adenoma. Is this coded to myoepithelial carcinoma (8982/3) or carcinoma ex-pleomorphic adenoma (8941/3)? It is unclear how to arrive at the correct histology code using the current Solid Tumor Rules. |
Code myoepithelial carcinoma ex pleomorphic adenoma as carcinoma ex pleomorphic adenoma (CXPA) (8941/3) using Head and Neck Solid Tumor Rule H1 as this is a single histology. The WHO Classification of Head and Neck Tumors, 5th ed., describes CXPA as a rare epithelial and/or myoepithelial malignance arising in association with a primary or recurrent pleomorphic adenoma. The histologic type of the carcinoma component is usually recorded, in this case, myoepithelial carcinoma. |
N/A | N/A | 2022 |
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20220031 | Tumor Size/Neoadjuvant Treatment: If a patient discontinues neoadjuvant therapy and then has surgery, how is the pathologic tumor size coded with the pathologic tumor size greater than the clinical tumor size? Currently, we are instructed to code 999 for the pathologic tumor size when neoadjuvant therapy is given; what happens when neoadjuvant chemotherapy is discontinued after 3 cycles (plan for 4 cycles)? |
Assign 999 for pathologic tumor size when patient has received neoadjuvant therapy, even when neo-adjuvant therapy is not completed. Describe the details in text fields. |
N/A | Tumor size | 2022 | |
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20220035 |
Solid Tumor Rules/Histology--Bladder: How is histology coded for a transurethral resection of the bladder (TURB) diagnosis with multiple components? See Discussion. |
Examples: Bladder TURB: Invasive high grade urothelial carcinoma with poorly differentiated (40%), lipoid (5%), and sarcomatoid (55%) components. Bladder tumor base TURB: Invasive high grade urothelial carcinoma with poorly differentiated (65%) and sarcomatoid (30%) components. The Urinary Sites Solid Tumor Rules, histology coding rules, say to code the most specific histology or subtype/variant, regardless of whether it is described as majority, minority, or component. Poorly differentiated (8020) and sarcomatoid (8122) are both urothelial subtypes, but there is no rule to instruct how to code a tumor/tumors with multiple urothelial subtypes. |
Code histology as 8120/3 in the two examples using Note 1 in the Urinary Sites Solid Tumor Rules, instruction 1 of the Coding Histology section. The subtypes/variants or components must describe a carcinoma or sarcoma in order to code a histology described by those terms. |
Bladder | Histology | 2022 |
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20220033 | When coding the Covid testing results, does SEER have any guidance on whether or not at home tests fall within reportability? For instance, if a medical provider says pt tested positive on an at home test, do we record that? |
When you have information about home COVID tests, record this information. For example, if the home test was positive record as follows: COVID-19 rapid viral antigen test POS 08/09/2022 |
N/A | N/A | 2022 | |
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20220032 | Reportability/Histology--Testis: Is micropapillary serous borderline tumor reportable? Pathology states Testis (C621) radical orchiectomy: Micropapillary serous borderline tumor. |
We consulted an expert genitourinary pathologist who advises that micropapillary serous borderline tumor of the testis is reportable. He states "it is the same neoplasm as in the ovary. It arises from tissue (tunica vaginalis) surrounding the testis so is a paratesticular neoplasm." Please note: not all borderline tumors are reportable and this diagnosis is an exception because it is assigned /2 in ICD-O-3.2. It is reportable for cases diagnosed Jan 1, 2021 and later. |
Testis | Histology | 2022 | |
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20220039 | Reportability/Histology--Eye: Is “squamous mucosa with high grade dysplasia” equivalent to a diagnosis of “high grade squamous dysplasia?” See Discussion. |
A conjunctival biopsy final diagnosis is squamous mucosa with moderate to high grade dysplasia. The diagnosis comment states that immunostains were performed and confirm squamous histology. This seems to imply a high grade squamous dysplasia, rather than a non-reportable high grade dysplasia. Does this case meet the criteria for reportable high grade squamous dysplasia? |
Squamous mucosa with high grade dysplasia is the same as high grade squamous dysplasia in the conjunctiva and is coded to 8077/2. |
Eye | Histology | 2022 |
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20220036 | Solid Tumors Rules/Histology--Head and Neck: How is histology coded for head and neck primaries when a tumor is diagnosed as an invasive squamous cell carcinoma with multiple subtypes? See Discussion. |
Example Case 1: 2022 mobile tongue tumor biopsy shows squamous cell carcinoma, basaloid non-keratinizing type. Example Case 2: 2022 base of tongue mass biopsy shows squamous cell carcinoma, basaloid non-keratinizing type, p16 positive. Table 5, Note 2 (Head and Neck Equivalent Terms and Definitions) instructs us to code non-keratinizing squamous cell carcinoma which is p16 positive to 8085 (Squamous cell carcinoma HPV-positive), ignoring the non-keratinizing subtype. Does p16 or HPV positivity also take priority over multiple subtypes (basaloid non-keratinizing type)? |
Assign 8083/3, basaloid squamous cell carcinoma (BSCC), in both examples. It is more important to capture the variant than to code 8085 or 8086. WHO Classification of Head and Neck Tumors, 5th ed., states that BSCC is a distinctive form of SCC, characterized by prominent basaloid morphology, squamous differentiation, and aggressive behavior. Some primary sites capture p16 status as a Site Specific Data Item; you may record the p16 results when that is the case. |
Head & Neck | Histology | 2022 |
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