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Report Produced: 11/01/2025 20:49 PM

Report Question ID Question Discussion Answer Year
20021184 EOD-Lymph Nodes--Head & Neck: When a physician provides only "Stage IV" (i.e., an abbreviated stage) for a right posterior tongue primary with lateral extension into the oropharynx and hypopharynx, can you assume "palpable" level 2, 3 and 5 lymph nodes are involved?

For cases diagnosed 1998-2003:

Code the EOD-Lymph Nodes field to 9 [Unknown], based on the information provided.

The physician's statement of an N category from a TNM may be used to determine lymph node involvement in the absence of other information. However, you cannot assume nodal involvement based on the incomplete staging information of "Stage IV" for a base of tongue primary. For this primary site, extension into the hypopharynx from this primary is equivalent to T4/Stage IV. Therefore you cannot assume the clinician's assessment of the case as Stage IV represents his assessment of lymph node involvement.

 2002
20020057 Histology (Pre-2007)--Melanoma: What code is used to represent the histology "radial growth phase: melanoma, superficial spreading type; vertical growth phase: epithelioid type"? See discussion. Can the "growth phase" be used to code histology? If so, would the histology be epithelioid cell melanoma (8771/3)?

For tumors diagnosed prior to 2007:

Code the Histology field to 8771/3 [epithelioid cell melanoma]. The "growth phase" information in this case describes the horizontal spread and the "invasive" or vertical growth through the layers of skin.

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
20021002 Histology (Pre-2007)--Breast: What code is used to represent the histology "ductal carcinoma in situ with comedo necrosis"? See discussion.

SEER distributed breast questions to the Advisory Group made up of pathologists from different SEER regions. One question dealt with the terms comedo type, comedo necrosis and comedocarcinoma. Per the Advisory Group, "Do not code comedo necrosis. These three phrases each represent a different level of diagnosis and can't be compared. "Comedocarcinoma" is an established diagnosis of in situ carcinoma and should be coded as such. "Comedo type" refers to a type of intraductal cancer; whether it is considered to be a true diagnosis is probably still equivocal. "Comedo necrosis" refers to a description of cellular pathological events that occasionally occur within an intraductal tumor of comedo type, which should not be coded at all."

Per the SEER preferred answer: Comedo type = comedocarcinoma. Ignore comedo necrosis.

For tumors diagnosed prior to 2007:

Code the Histology field to 8500/2 [ductal carcinoma in situ].

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
20021147

Other Cancer Directed Therapy--Hematopoietic, NOS: Is "aspirin" treatment for primary polycythemia? See discussion.

Aspirin is listed as treatment for "thrombocythemia" in the Abstracting and Coding Guide for the Hematopoietic Diseases but not for "primary polycythemia."

Do not code aspirin as treatment for primary polycythemia (polycythemia vera).

 2002
20021090 Primary Site--Ovary/Peritoneum: How should the Primary Site field be coded when no resection is done and it is uncertain whether the primary site is in the ovary or the peritoneum? See discussion. CT: ascites, omental cake and peritoneal studding. H&P impression: probable ovarian or peritoneal primary. Repeat CT: no enlarged adnexal mass seen to suggest ca of ovary, but possibility couldn't be ruled out. Omental bx: Metastatic ca. Comment: "IHC stains have been performed and are not typical of ovarian ca, although do not exclude an ovarian primary." After the bx, there were two clinical diagnoses written a month apart with no evidence of further work-up between those dates. The first diagnosis was "ovarian ca". The second was "Peritoneal carcinomatosis 2 month ago; Primary is unknown, possibly ovarian."

Use the best information available to identify the primary site. In this case, it is the physician's clinical assessment. Code the Primary Site to C56.9 [Ovary] for this example because the ovary is indicated to be the primary site according to the physicians involved.

When there is no surgical procedure involving the removal of the ovaries, code the Primary Site based on the clinical assessment of the disease location. If the disease is only noted to be in the peritoneum, code site to peritoneum, NOS. If the disease is seen clinically in both the ovary and the peritoneum, code site to ovary.

 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
20021188 Multiple Primaries (Pre-2007)--Testis: How many primaries should be reported when seminoma is diagnosed simultaneously in both testicles and both tumors are encapsulated?

For tumors diagnosed prior to 2007:

Report this cases as two primaries, unless there is information in the record confirming one primary.

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
20021055 EOD-Extension--Liver: Can we use CT scan descriptions such as "portal vein thrombosis" or "extensive infiltration of the liver" or "diffuse infiltration of the liver" to code extension for liver primaries? See discussion.

1. Would you code portal vein involvement for a CT scan description of "portal vein thrombosis"?

2. Would you code more than one lobe of the liver as involved for CT scan descriptions of "extensive infiltration of the liver" or "diffuse infiltration of the liver"?

For cases diagnosed 1998-2003:

1. No. Thrombosis can be caused by non-cancerous conditions.

2. Yes. Code the EOD-Extension field to 65 [Multiple (satellite) nodules in more than one lobe of the liver] when "extensive infiltration" or "diffuse infiltration" is stated.

 2002
20021072 EOD-Size of Primary Tumor--Breast: The path report provides a size for both the Paget disease and the underlying intraductal component in the breast. Should we assume the Paget disease to be invasive and code the size of the primary tumor to that invasive component? See discussion. For example, path diagnosis for resection gave the size of the Paget disease as 1 mm and the size of the underlying intraductal tumor as 4 cm. Should size for this breast case be coded to 040 or 003, less than 3 mm.

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 040 [4 cm], the size of the larger underlying intraductal tumor. Paget disease is classified according to the size of the underlying in situ or invasive tumor. Paget with an underlying in situ tumor is staged as in situ to match the AJCC classification of this disease process.

 2002
20021183 Primary Site--Head & Neck: What site code is used to represent the following head and neck primary where there is not a clear statement of primary site? See discussion.

6/29/02: PE: 2-3 cm mass in the posterior pharynx that seems to arise from the right side of back of tongue.

6/29/02 CT soft tissue of neck: 3 cm right sided oropharyngeal mass, possibly arising from right tongue mass. There is near occlusion of airway at this level.

7/3/02 Excision of oropharyngeal tumor: Palpated mass could clearly be felt coming off the right lateral tongue in approximately the mid portion of the tongue near the tonsillar base.

 Code the Primary Site field to C02.9 [tongue, NOS], based on the information provided. 2002