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Report Produced: 02/11/2026 23:31 PM

Report Question ID Question Discussion Answer Year
20031103

Reportability--Ovary: Is a Stage IIIC serous borderline tumor (micropapillary type) of the ovary diagnosed in 2003 reportable?

Serous borderline tumor of the ovary diagnosed in 2003 is not reportable to SEER. The behavior code is /1 in ICD-O-3. The high stage does not make this borderline tumor reportable. 2003
20031194

Terms of involvement--Lung: Is "intense uptake" described on a PET scan an indication of involvement? See Description.

We are seeing increasing use of PET scans as diagnostic tools for cancer. PET scans use different terminology than the ambiguous terms listed in the EOD manual. Could we please have guidelines for interpreting PET scans?

Example: Patient with right lung cancer. PET scan showed intense uptake in the mediastinum and in the hilum. Can we code "intense uptake" as involvement of mediastinal and hilar lymph nodes?

 Do not interpret "intense uptake" as involvement. Look for a statement of involvement or other terminology, such as "highly suspicious," "strongly suspicious for" malignancy, involvement, etc. 2003
20031004 Surgery of Primary Site--Skin: When would one use codes 30-33 for this field on a skin primary?

Surgery of Primary Site codes 30-33 under "skin" are used for various types of biopsies followed by a gross excision of the lesion. The two procedures (biopsy and gross excision) may be performed on different days, at different facilities, by different physicians as long as both procedures are performed during the first course of treatment.

Answer applies to both pre-2002 and 2003+ surgury code definitions.

 2003
20031119 EOD-Extension/EOD-Lymph Nodes--Colon: For this primary, under which field are satellite tumor nodules in mesenteric adipose tissue coded? See Description.

Sigmoid colon, low anterior resection: Invasive adenocarcinoma, 5.5 cm greastest dimension, moderately differentiated. Tumor invades through muscularis propria, into mesenteric adipose tissue. No penetration of visceral peritoneum. Proximal, distal, and radial margins free of tumor. Satellite tumor nodule present within mesenteric adipose tissue, 1.5 cm diameter, located 2.8 cm from main bowel wall tumor. Ten lymph nodes identified, with no evidence of metastatic tumor.

Comment: The satellite tumor nodule present within the mesenteric adipose tissue has an infiltrating, irregular contoured appearance and does not appear to represent a previously replaced lymph node. This appears to be a local metastasis with histologic features most commonly associated with venous invasion (see AJCC Cancer Staging Handbook, Sixth Edition, 2002, page 131 for current staging terminology).

 For cases diagnosed 1998-2003: For EOD, each grossly detectable nodule in the regional mesenteric fat is counted as one regional lymph node. 2003
20031133 First Course Treatment--Thyroid: Is hormone replacement following total thyroidectomy coded as first course treatment for all thyroid cases?

Code Hormone therapy as 01 [Hormone therapy administered as first course therapy] when thyroid replacement therapy is part of the first course of treatment for follicular or papillary thyroid cancer following thyroidectomy.

Thyroid hormone replacement therapy has a treatment effect on differentiated (follicular and papillary) carcinomas of the thyroid. This treatment effect is not seen for most medullary and undifferentiated thyroid cancers.

 2003
20031078 EOD-Lymph Nodes--Colon: Are "multiple submucosal lymphoid collections infiltrated with tumor" or "lymphoid areas" coded as lymph node involvement, similar to the way nodules in the pericolic fat are coded? See Description. For an adenocarcinoma in the colon, under the "lymph node" section of the final path diagnosis it states "multiple submucosal lymphoid collections infiltrated with tumor" in addition to "one of two involved lymph nodes." The micro description states "There are multiple small lymphoid areas with tumor. A definite node excised from the mesentery shows...replacement of stroma and an additional very small node shows no tumor."

For cases diagnosed 1998-2003: No, do not code tumor infiltration of lymphoid collections or lymphoid areas as lymph node involvement.

However, code lymph node involvement for this case as 3 [mesenteric, NOS] because a mesenteric node is involved.

Regarding tumor infiltration of lymphoid collections or lymphoid areas from our pathologist consultant: Unless the anatomy of lymph node is evident (sinuses, trabeculae, primary and secondary follicles) these aren't lymph nodes and should not be coded as such. Unless there is evidence to the contrary in the path report, I would suggest that this be considered intramural spread, not lymph node spread.

 2003
20031006 EOD/Surgery of Primary Site--Melanoma: If a melanoma primary site is other than skin, vulva, penis, or scrotum should these fields be coded using melanoma schemes? See discussion. Should a melanoma of the cervix be coded using the melanoma or the cervix schemes for these fields? For cases diagnosed 1998-2003: Use the EOD and surgery code schemes for cervix uteri. The EOD scheme for melanoma excludes melanoma of the cervix uteri. The surgery code scheme for skin excludes cervix uteri. 2003
20031066 Histology (Pre-2007): Is 8524 [lobular mixed with other carcinoma] or 8490 [signet ring cell carcinoma] used to represent a diagnosis of "infiltrating lobular with signet ring features?"

For tumors diagnosed prior to January 1, 2004:

According to our pathologist consultant, for this specific case, code to 8490 [Signet ring cell carcinoma].

Our pathologist states: "Signet ring cell carcinoma is most often a variant of lobular carcinoma (as it appears to be in this case - it is less frequently a variant of ductal), and I think it's appropriate to code it as such. Coding to lobular would also be ok, though that would lose the special feature of the signet ring cells. I would rather not code to 8524, since it is not really a mix of lobular and something else."

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.

 2003
20031086 EOD-Clinical Extension--Prostate: Must all three criteria be met (an elevated PSA; documentation that the physical exam was negative; and, if a TRUS was done, there is documentation that the findings were negative) in order to code this field to 15 [Tumor identified by needle by elevated PSA]?

For cases diagnosed 1998-2003:

Refer to the Prostate EOD Coding Guidelines, Final version distributed to SEER Registries 6/20/2001.

Prostate clinical EOD extension code 15 is used when all three criteria are met as listed on page 3 of the Prostate EOD Coding Guidelines. Meeting 1 or 2 of the 3 criteria is not sufficient for code 15. PE must be done and documented as negative. TRUS may or may not be done, but if done, must be documented as negative. PSA must either be elevated or there is no documentation about the PSA.

Codes 20 and 23-24 would be used with positive physical exam or positive TRUS.

Use codes 30-34 when there is no documentation that the physical exam was negative, or no documentation that the TRUS was negative, or when the prostatic apex is involved.

 2003
20031042 Histology (Pre-2007): How are the following four histologies coded: 1) Adenocarcinoma with focal mucinous adenocarcinoma; 2) Adenocarcinoma with focal areas of bronchioalveolar adenocarcinoma, 3) Mixed infiltrating duct and focal medullary carcinoma, and 4) Mixed infiltrating duct and focal medullary carcinoma? See Description.

1. How do we code colon: Adenocarcinoma with focal Mucinous adenoca? 8140/3 or 8255/3?

2. A lung lesion with predominant adenoca with focal areas of bronchioalveolar adenoca? 8140/3 or 8255/3?

3. Mixed infiltrating duct carcinoma and medullary ca? 8510/3 or 8255/3?

4. Mixed infil duct ca and focal medulary ca? 8510/3 or 8255/3?

For tumors diagnosed prior to 2007:

1. 8140/3, Adenocarcinoma. Mucinous has a specific rule (see sinq 20010075): Include the mucinous component only if it is 50% or more of the tumor. "Focal" is not a majority term.

2. 8250/3, Bronchiolo-alveolar adenoca. Code the more specific histology.

3. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

4. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

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.

 2003