| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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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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20220040 | Laterality--Brain and CNS: Can Laterality be coded as 5 (midline) for a sella turcica meningioma (or tuberculum sellae meningioma) when no other statement regarding tumor laterality is documented? See Discussion. |
Laterality is often not noted for these sella turcica meningiomas; therefore, Laterality is often coded as 9 (Unknown). Because the sella turcica appears to be a midline structure in the base of the skull, is Laterality code 5 (midline) more appropriate when additional information is unavailable? |
You may assign code 5 (Paired site: midline tumor) for laterality of a meningioma of the sella turcica (C700). The 2022 SEER manual states in Laterality coding instruction 5: Assign Laterality code 5 only when the primary site is C700, C710-C714, C722-C725, C443, C445. Do not assign code 5 to sites not listed in 5.a. Note that code 9 is for paired sites and there is no information concerning laterality. Document laterality information in the appropriate text field. Note: Laterality does not factor into the CNS Solid Tumor rules. |
Brain and CNS | Laterality | 2022 |
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20220016 | Histology--Thyroid: What is the correct histology code for a follicular carcinoma, minimally invasive, oncocytic variant of the thyroid? See Discussion. |
There is an ICD-O histology code for follicular carcinoma, minimally invasive (8335/3) as well as follicular carcinoma, oxyphilic cell (8290/3). Per SINQ 20150045, the term oncocytic is synonymous with oxyphilic in this context. The Multiple Primaries/Histology General Instructions and histology rules do not include the term “variant” as a term that can be used to code a further histologic subtype. The term “variant” can be used for the Other Sites (non-updated STR sites) when the ICD-O-3.2 (or ICD-O-3 for older cases) provides the term “variant” in the histology name. |
Code follicular carcinoma, minimally invasive, oncocytic variant of the thyroid to follicular carcinoma, oncocytic variant (8290/3). The term "variant" is commonly used in thyroid histologies and if appropriate, used to determine histology code. The WHO Classification of Tumors of Endocrine Organs, 4th edition, lists synonyms for 8290/3 as Hürthle cell carcinoma; oncoycytic carcinoma; oxyphilic carcinoma; follicular carcinoma, Hürthle cell type; and follicular carcinoma, oncocytic variant. |
Thyroid | Histology | 2022 |
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20220044 | Solid Tumor Rules (2018/2021)/Histology--Head & Neck: What is the histology code for a uvula (C052) primary with histology of squamous cell carcinoma, conventional (keratinizing) and p16 result is negative? See Discussion. |
The Schema ID for C051 (soft palate, NOS) and C052 (uvula) is Oropharynx (either 00100 or 00111 depending on p16). The Solid Tumor Rules Manual includes these site codes are under Table 4: Tumors of Oral Cavity and Mobile Tongue site group for histology coding. We are aware of the notes that allow coding of 8086 for keratinizing SCC, HPV-negative for sites listed in Table 5 only. However, it seems like C051 and C052 were incorrectly omitted from Table 5 (mis-categorized under Table 4). Can we code 8085 for 8086 for C051 or C052 based on p16/HPV status? |
Assign code 8071/3 for keratinizing squamous cell carcinoma. Codes 8085 and 8086 are only valid for the Head and Neck sites listed in Table 5 beginning with cases diagnosed 01/01/2022 and forward. |
Head & Neck | Histology | 2022 |
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20220009 | First Course Therapy/Reason for No Surgery of Primary Site: What code should be used for Reason for No Surgery of Primary Site in 2020 in situations affected by the pandemic when abstracting all sites? See Discussion. |
Example: Patient scheduled for left nephrectomy on 3/10/20 due to left renal papillary renal cell carcinoma diagnosed on 2/11/20 via needle core biopsy. Abstract indicated surgery was cancelled due to the pandemic. Abstract also indicated the surgery was not rescheduled. |
There is no available code that fits this situation. We recommend assigning code 6 (Surgery of the primary site was not performed; it was recommended by the patient’s physician, but was not performed as part of the first course of therapy. No reason was noted in patient record.) and documenting the situation in a text field. |
N/A | N/A | 2022 |
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20220037 | Histology--Brain and CNS: What is the histology code of a primary papillary epithelial tumor of the sella (PPETS)? See Discussion. |
The pathology report states this is a rare entity described in case reports and not incorporated into the WHO classification of tumors. A subsequent endocrinology note stated “papillary tumor, benign by path; tumor was not an adenoma; based on one Mayo study, the recurrence risk is low.” |
Assign code 8000/0. This is an emerging histology and not yet recognized by the World Health Organization. Document the details in text fields. It might also be useful to document this SINQ question in text. |
Brain and CNS | Histology | 2022 |
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20220013 | Reportability/Histology--Kidney: What is the histology and behavior of a papillary renal neoplasm with reverse polarity? See Discussion. |
Patient had a partial nephrectomy with final diagnosis of papillary renal neoplasm with reverse polarity. Diagnosis comment states: Papillary renal neoplasm with reverse polarity is currently considered to be a histologic variant of papillary renal cell carcinoma; however, recent studies suggest that it has a very indolent clinical behavior. |
Report papillary renal neoplasm with reverse polarity as 8260/3. According to the WHO Classification of Urinary and Male Genital Tumors, 5th edition, this is a distinctive pattern of papillary renal cell carcinoma that has been recently recognized. These tumors have recurrent mutations of KRAS, differing from typical papillary renal cell carcinoma. We recommend that you include with reverse polarity in your histology text to differentiate this entity from others classified in 8260/3. |
Kidney, renal pelvis | Behavior, Histology | 2022 |
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20220024 | Update to Current Manual/Residence at diagnosis: Would an exchange student be a temporary resident of the SEER area or a non-resident? See Discussion. |
A 17 year old exchange student was brought into the hospital with appendicitis. The patient had an appendectomy; there was no follow up treatment. 5/27/2006 pathology report of vermiform appendix: Adenocarcinoid appendix <5 mm tumor limited to appendix. The patient has no record in Lexis Nexus and no social security number. The address is a post office box; additionally, the patient’s birthplace is Switzerland and is lost to follow up. |
Code the residence where the student is living for exchange students temporarily living in the U.S. Code the temporary address if known or the Post Office Box if unknown. We will add this scenario to the next release of the SEER manual. |
N/A | Residence at dx | 2022 |
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20220010 | EOD 2018/Heme & Lymphoid Neoplasms--Myeloid Sarcoma: How is Extent of Disease (EOD) Primary Tumor coded for a myeloid sarcoma with multifocal skin involvement? See Discussion. |
Patient has a diagnosis of myeloid sarcoma presenting as multiple erythematous papules and nodules on back, chest, right arm & shoulder. Oncologist did not mention any evidence or suspicion of an associated AML diagnosis. HemeRetic schema EOD Primary Tumor Note 1 states that myeloid sarcoma can be coded as localized (code 100) or systemic (code 700). It is not clear what would qualify as systemic disease for myeloid sarcoma. |
Assign code 100, localized, using the 2018 EOD Primary Tumor, HemeRetic schema, for the myeloid sarcoma with skin involvement since only the skin is involved. Use code 700, distant or disseminated, when multiple organs are involved. |
Heme & Lymphoid Neoplasms | EOD Primary Tumor | 2022 |
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20230038 | Histology/Heme & Lymphoid Neoplasms--Mycosis Fungoides: What is the histology code for lymphomatoid papulosis that transforms initially to mycosis fungoides (MF)/cutaneous T-cell lymphoma (CTCL) and subsequently to CTCL with large cell transformation, and is it a new primary? See Discussion. |
Disease History 2018 - Lymphomatoid papulosis (non-reportable) 2020 - Transform to CTCL (and called Mycosis Fungoides specifically) (CTCL/MF same primary) 2021 - Transform to CTCL with large cell transformation |
Abstract a single primary and assign code 9700/3 for MF. According to our subject matter expert, this is all MF. When MF progresses, there can be large cd30 positive T cells. This is not the same as anaplastic large cell lymphoma. |
Heme & Lymphoid Neoplasms | Histology | 2023 |
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