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20021136 | Date of Diagnosis/Histology (Pre-2007): How should we code these fields for "atypical fibroxanthoma" of the left cheek diagnosed in October 1999 that is followed by a June 2000 punch biopsy with a microscopic description in the pathology report of "superficial form of malignant fibrous histiocytoma"? See discussion. | Should the diagnosis date for the malignant fibrous histiocytoma be October 1999 because it is called "residual/recurrent atypical fibroxanthoma" in the June 2000 final diagnosis of pathology report? In the microscopic description it is called a "malignant fibrous histiocytoma." Per an August 2000 outpatient note, "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." | For tumors diagnosed prior to 2007:
Code the Histology field to 8830/3 [Malignant fibrous histiocytoma]. Code the Date of Diagnosis to October 1999 based on the clinician's statement of "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." Assume that this statement means that the physician re-evaluated the clinical course and decided that the original tumor must have been malignant.
If the original slides are reviewed and the diagnosis is changed to a malignancy or if the clinician states that the first occurrence was obviously malignant, backdate the date of diagnosis to the first occurrence.
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. |
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20021088 | Multiple Primaries (Pre-2007)--Vulva/Vagina: SEER Program Code Manual rule #3 on page 11 states "If a new cancer of the same histology is diagnosed in the same site after two months, consider this new cancer a separate primary unless stated to be recurrent or metastatic. Should vulva and vagina be exceptions to rule #3, as are prostate and bladder? |
For tumors diagnosed prior to 2007: No. There is no exception for vulva or vagina. 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. |
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20021066 | Histology: How do we code this field when a less representative specimen has a more specific morphology? See discussion. | Example: Biopsy revealed endometrioid adenocarcinoma and the resection demonstrated adenocarcinoma, NOS. Do we code histology per the most representative sample, or to the more specific morphology? | Code the histology using the pathology report from the most representative specimen, even if that histology is less specific. For the case example above, code 8140 [adenocarcinoma, NOS]. The rationale is that a diagnosis from a smaller specimen will be less accurate and less representative of the true histology compared to a larger tumor specimen. |
2002 |
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20021087 | Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are represented when a1998 invasive squamous cell carcinoma of the true vocal cord is followed by a 1999 diagnosis of in situ squamous cell carcinoma of the true vocal cord (called "recurrent" by the clinician), and in 2001 there is another invasive squamous cell carcinoma of the true vocal cord (no statement of recurrence)? Would your answer be any different if no statement of "recurrent" had been made in 1999? | For tumors diagnosed prior to 2007:
Code this case as two primaries, an invasive true vocal cord primary in 1998 and another invasive true vocal cord primary in 2001.
If there had been no statement of recurrence for the 1999 in situ diagnosis and the 1999 diagnosis was more than two months following the 1998 diagnosis, this case would be coded as three primaries.
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. |
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20021081 | Multiple Primaries (Pre-2007)--Melanoma: Many melanoma patients have multiple occurrences over time that are not called recurrent and often are even in the same skin subsite, some in situ only and others alternating between in situ and invasive. Should these multiple occurrences really be new primaries? |
For tumors diagnosed prior to 2007: Unless it is stated to be a RECURRENT or METASTATIC melanoma, record each melanoma as a separate primary when: 1. The occurrences are more than two months apart. 2. The fourth digit of the ICD-O topography code for skin [C44._] is different . 3. The first three digits of ICD-O-3 morphology code are different. 4. An in situ melanoma is followed by an invasive melanoma. 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. |
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20021007 | Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])? | For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS]. | 2002 | |
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20020009 | EOD-Extension--Lymphoma: What code is used to represent this field for a lymphoma that involves the spleen and lymph nodes above the diaphragm (e.g., involvement of only the spleen below the diaphragm and cervical lymph nodes above the diaphragm)? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 32 [30 + involvement of the spleen; III S]. The spleen is counted twice (once as the spleen and a second time as a lymph node region below the diaphragm). As a result, the EOD-Extension field is coded to reflect involvement of lymph node regions on both sides of the diaphragm plus involvement of the spleen. See Note 1 on the EOD scheme that states "Any lymphatic structure is to be coded the same as a lymph node region." |
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20020002 | Date Therapy Initiated: What date should be entered in Date Therapy Initiated when treatment follows a surgical procedure that is not coded under Surgery of Primary Site? See discussion. | If a patient has a surgical procedure that is not coded in the Surgery of Primary Site field and then the patient undergoes additional first course of treatment, such as radiation therapy, how should the Date Therapy Initiated field be coded? | In this example, code the Date Therapy Initiated field to the date of the first surgical procedure. If a SEER edit is triggered, please notify us. | 2002 |
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20021036 | EOD-Extension--Urinary Tract: Can the rules used to code bladder extension involving the term "no involvement of muscularis/and no mention of subepithelium/submuscosa" be used to code extension for other urinary tract primaries, such as ureter? | For cases diagnosed 1998-2003:
No. The inferred descriptions of noninvasion apply to bladder cases only. |
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20021117 | Multiple Primaries (Pre-2007)--Bladder/Prostatic Urethra: Is the prostatic urethra a new primary for a case with a history of recurrent noninvasive bladder cancer that was subsequently diagnosed with transitional cell carcinoma in situ of the prostatic urethra and had a subsequent clinical diagnosis of "refractory bladder carcinoma"? | For tumors diagnosed prior to 2007:
If the histology of the bladder primary is "transitional cell carcinoma" or "papillary transitional cell carcinoma," do not code the prostatic urethra as a new primary. This is probably a case of intraluminal (mucosal) spread of the original tumor, rather than separate primaries. The clinical diagnosis supports this view.
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 |
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