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Report Produced: 10/29/2025 06:20 AM

Report Question ID Question Discussion Answer Year
20021060 EOD-Size of Primary Tumor: The EOD Manual instructs us not to code the size of a cyst. Can we code the size of tumor lesions described as being multicystic, multiloculated, or as a complex mass with cystic areas? See discussion.

Example 1: Large multicystic ovarian mass lesion measuring 10 cm. Sections through the specimen show a multicystic and solid mass with abundant fluid exuding from the cut surfaces (Size of the solid portions is not stated).

Example 2: A brain MRI: 9-cm. complex mass with cystic areas.

For cases diagnosed 1998-2003:

Yes, if the cystic mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field based on the size of the mass in the absence of a more precise tumor size description. For the examples in the discussion section, code the EOD-Size of Primary Tumor field to: 1) 100 [10 cm]. 2) 090 [9 cm].

As a point of interest, the size of tumor for ovarian and brain primaries is not used in either analysis or as a prognostic indicator for survival. Therefore, spending time separating the cystic and solid portions of the tumor is unnecessary.

 2002
20021137 Multiple Primaries (Pre-2007)--Soft Tissue: Does SEER agree that one primary of the soft tissues of pelvis [C49.5] should be reported when a pathologic diagnosis for bilateral herniorrhaphies is "right and left inguinal hernias with low grade spindle cell sarcoma"?

For tumors diagnosed prior to 2007:

Yes. This is one primary and should be coded to C49.5 [Connective, subcutaneous and other soft tissue of pelvis]. According to Rule A in ICD-O-3, the type of tumor ("sarcoma") indicates origin from a particular tissue, resulting in the primary site code of C49.5 [Inguinal region, NOS] for this sarcoma.

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
20021133

First Course Treatment--All Sites: The patient has undergone part of the planned first course of treatment when a metastatic deposit is identified. If the patient continues with the planned first course of treatment, should the modalities of treatment given after the metastatic deposit is discovered be included in the coding of the first course of cancer-directed treatment fields?

Yes, those modalities should be counted as part of first course of cancer-directed treatment if the patient continues with the planned first course. For example, if patient has the originally planned type of surgery, radiation, or drug protocol, then code the given treatment as first course.

Caution: It is not a change in the treatment plan if the drugs are changed but the action of the drugs remains the same. This is still first course. However, if the treatment is changed from a chemotherapy drug to a hormonal drug following the discovery of the mets, do not code the hormonal therapy as first course.

 2002
20021150 SEER Guidelines Over Time: Should we apply the current guidelines to previously missed older cases now being reported to the central registry? See discussion.

1. We receive "straggler" cases for coding that were diagnosed when previous coding schemes and guidelines were applicable. When a specific guideline is in place for a given time period and is later changed in some way, we try to use the specific guideline that was in place at the time of diagnosis when coding the incoming case. However, it is not always possible to remember or to be able to access those old guidelines.

2. There are situations when coding old cases that have no applicable guideline for the older diagnosis years but current SEER documentation informs the coder how to handle the situation. For example, in the SEER Program Code Manual (3rd ed), 3 new guidelines were added for coding of differentiation. There were no guidelines in the previous SEER manual that specifically covered those situations. Should we use the current rules in coding differentiation on the older incoming case?

 Code all fields according to the instructions that were in effect at the time the case was diagnosed. If the old guidelines are unavailable or non-existent, code the case in the current scheme. The year the case was abstracted will indicate that the case was a late entry into the system and that could account for the differences in coding seen by a reviewer. 2002
20021012

EOD-Extension--Lymphoma: How do you code stage and EOD for an extranodal lymphoma with bilateral involvement of a paired site? See discussion.

For example, we frequently see cases of lymphoma occurring in bilateral orbits, or both lungs. This issue was discussed at a 1991 SEER meeting with the tentative answer being that lymphoma involving both organs of a paired site will be coded as stage I (e.g., both eyes or both lungs), as this would be contiguous disease. However, an extranodal lymphoma involving tissue of both limbs (e.g., soft tissue of both arms) will be coded as stage IV because this represents wide areas of involvement that have no connection.

For cases diagnosed 1998-2003:

Bilateral involvement of an extralymphatic paired organ is coded as involvement of a single extralymphatic organ or site for lymphomas. The EOD extension code would be at least 11 (Stage IE). Staging lymphomas of any site depends on whether one or more lymph node regions and/or extralymphatic organs are involved, and whether sites on one or both sides of the diaphragm are involved.

 2002
20021004 Histology: What code is used to represent the histology for the abbreviation "ca"? See discussion.

The abbreviation "ca" results in inconsistency when coding histology by a group of coders. Many abbreviation guides list both cancer (8000/3) and carcinoma (8010/3) as definitions for "ca." Page 261 of the SEER Self Instructional Manual, Book 5 lists carcinoma as the definition for "ca."

Example: What histology is used for a case with a clinical diagnosis of "recently diagnosed uterine ca" with metastasis to the pelvic lymph nodes?

For uterine primaries, code the abbreviation "ca" to 8010/3 [carcinoma, NOS].

When coding death certificate only (DCO) cases, if the site is coded to an unknown primary and no specific histology information is available other than the abbreviation "ca," interpret ca as cancer (8000/3) per NAACCR Procedure Guidelines for Registries, Series V; Resolving Death Clearance Issues, page V-15.

 2002
20020053 EOD-Extension--Meninges: How do you code extension for a malignant meningioma that invades into the adjacent brain tissue?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 60. Code 60 is defined as a brain tumor that extends into the meninges. It is also the appropriate code to use for a tumor that extends from the meninges to the brain.

 2002
20021129 Histology/Date of Diagnosis--Hematopoietic, NOS: What code is used to represent histology for a June 2001 diagnosis of "myelodysplastic syndrome" followed by a September 2001 bone marrow biopsy diagnosis of "myelodysplasia evolving into an acute leukemic state"?

For cases diagnosed prior to 1/1/2010:

Code the Histology field to 9989/3 [myelodysplastic syndrome] and the Date of Diagnosis field to June 2001.

For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

 2002
20021174 Histology (Pre-2007)/Grade, Differentiation--All Sites: When the original pathology reports diagnosis indicates a grade and the review of slides (ROS) pathology report does not give a grade, can you code the histologic type from the ROS and the grade from the original pathology report? See discussion. For example, if the original diagnosis is "poorly differentiated carcinoma" and the ROS diagnosis is "squamous cell carcinoma," would the morphology code be 8070/33?

For tumors diagnosed prior to 2007:

Yes. Code the Histology and Grade, Differentiation fields to 8070/33 [poorly differentiated squamous cell carcinoma]. Code the higher grade when different grades are specified for the same specimen and code the more specific morphology (i.e., squamous cell carcinoma rather than carcinoma, NOS).

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
20021140 EOD-Extension--Head & Neck: How do you code extension for a supraglottic larynx primary with "pre-epigolottic space" invasion?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 65 [Pre-epiglottic tissues]. Extension to "pre-epiglottic space" is equivalent to extension to "pre-epiglottic tissue."

 2002