Multiple Primaries (Pre-2007): Are simultaneous tumors of the rectosigmoid junction and rectum counted as two primaries? See Description.
On the same day in 1998, a patient was found to have a T3 adenocarcinoma of the rectosigmoid junction and an in situ adenocarcinoma in a villotubular adenoma in the lower rectum. These would be the same histology if they are in the same site.
Are C199 and C209 the same site? They are listed in ICD-O-2 (pg. xxxvii) and in ICD-O-3 (pg. 36), but they are not listed in the SEER Program Manual on page 9 as the same site. Is this one primary or two?
For tumors diagnosed prior to 2007:
Abstract two primaries for the example above, according to the main rule on page 7 in the SPCM. Rectosigmoid junction (C19) and rectum (C20) are in different 3-digit ICD-O-3 topography code categories. Rectosigmoid junction and rectum are not included in the exceptions to the main rule and, therefore, do not appear on page 9 of the SPCM.
The table on page 9 is not identical to the table in ICD-O-3. Two site combinations are listed in ICD-O-3, but not in the SEER table: C19 (rectosigmoid junction) and C20 (rectum); C40 (bones of limbs) and C41 (other bones). Abstract multiple tumors in the rectosigmoid junction and rectum as separate primaries. Abstract multiple tumors in the bones of the limbs and other bones as separate 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.
EOD-Size of Primary Tumor: Pathologist states that the size of the tumor is difficult to measure but is greater than 3cm but less than 5cm. How would we code the tumor size?
For cases diagnosed 1998-2003:
Code the largest dimension mentioned, since that is the standard rule for coding tumor size. Keep in mind that tumor size is not used in analysis for certain sites such as stomach, colon & rectum, ovary, prostate, and urinary bladder. Tumor size is important for analysis for certain sites such as lung, bone, breast, and kidney.
Summary Stage 2000--Colon: How should this field be coded for involvement of "pericolonic fat, NOS" when there is no mention of whether the fat is sub-serosal or supra-serosal? See Description.
In the summary staging manual pericolic fat is listed under regional direct extension with no mention of whether sub-serosal or supra-serosal. According to our report the pathologist must specify whether involvement of pericolonic fat is of subserosal or supraserosal fat. If involvement of pericolonic fat was not specified as such, this should be localized vs regional direct extension.
Code Summary Stage as 2 [Regional by direct extension only].
In Summary Stage 1977 and 2000, pericolic fat is listed under Regional Direct Extension. If there is no indication by the pathologist that the involved fat is subserosal, code as Regional Direct Extension.
Primary Site--Head & Neck: What is the anatomical distinction among tonsillar fossa, tonsillar pillar, and tonsil NOS?
Operative findings describe a right tonsil three times the size of the left tonsil. Tonsil is dissected from the tonsillar fossa. There appeared to be no involvement of tumor below the tonsillar capsule.
The tonsil lies in an indentation called the tonsillar fossa. The tonsillar fossa is bordered on either side by the tonsillar pillars. The tonsillar pillars are part of the supporting structure of the throat opening.
Code C09.9 [Tonsil NOS] as the primary site for the case above.
Primary Site/Histology (Pre-2007)--Unknown & ill-defined site: How are these fields coded for a markedly atypical high grade malignant neoplasm diagnosed by a fine needle aspiration of a large iliac mass, right buttock area? See Description.
The diagnosis was made in Oct. 2002 by a CT guided fine needle aspiration of a large iliac mass, right buttock area. The cytology report says:
a. positive for malignant cells, markedly atypical high grade malignant neoplasm.
b. It is impossible to tell from this aspiration biopsy whether or not this represents a high grade sarcoma or a high grade carcinoma, but our consensus opinion is that this lesion is a high grade carcinoma.
The combination of soft tissue topography and carcinoma morphology is Impossible by SEER edits. How should we code this?
For tumors diagnosed prior to 2007:
Code the site to C76.3 [Pelvis, NOS]. Code the histology to 8010/34 [Carcinoma, NOS, high grade].
Unless there is better information available regarding the site, assign C76.3. The information provided above does not indicate the exact site of the mass.
Code the histology based on the consensus opinion stated above.
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.
Laterality--Head & Neck: Does the site code C098 need a laterality code? See Description.
In the SEER EOD-88 3rd edition, page 36, site code C098 does not need laterality. In the SEER Program code manual, 3rd edition, page 93, site code C098 is listed as a site that needs a laterality code 1-9.
Topography code C098 [Overlapping lesion of tonsil] requires a laterality code of 1-9. Follow the laterality guidelines in the SEER Program Code Manual.
EOD-Size of Primary Tumor--Prostate: Is this field coded to the size of a hypoechoic mass identified on a TRUS when there is no tumor size from the prostatectomy specimen?
For cases diagnosed 1998-2003: Ultrasound measurement of a malignancy can be used to code EOD-Size of Primary Tumor. Information on tumor size taken from imaging/radiographic techniques has low priority, just above physical examination.
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.
EOD-Extension--Head & Neck: If there is no mention of vocal cord mobility, do we code indicating normal vocal cord mobility or do we code EOD-Extension to a "localized, NOS?" See discussion.
How do we code EOD-extension for the following tumor of the supraglottic larynx? Limited stage small cell cancer of epiglottis per discharge signout. Physical exam revealed swelling of anterior aspect of epiglottis and narrowing of epiglottis. Neck without palpable masses. Laryngoscopy with biopsy and esophagoscopy showed extensive tumor involving entire laryngeal surface of epiglottis, extending onto aryepiglottic fold, onto false vocal cords and onto left true vocal cord. Ventricle on left side was obliterated with tumor. Right true vocal cord free of tumor. There is no information regarding vocal cord mobility. Biopsy of the left true vocal cord was negative. Should EOD-extension be coded to 20 [Tumor involves more than one subsite of supraglottis without fixation or NOS] or 50 [Localized NOS]?
For cases diagnosed 1998-2003, if vocal cord mobility is not mentioned, code as normal mobility. Code EOD-extension for the example case as 20 [Tumor involves more than one subsite of supraglottis without fixation or NOS].
EOD-Extension--Corpus Uteri: How is this field coded for a stage III A endometrial primary with positive pelvic washings, involvement of the omental serosa, and negative lymph nodes?
For cases diagnosed 1998-2003: Code EOD-extension as 85 [Metastasis]. According to our TNM consultant, Omental metastasis is M1, Stage IVB [EOD 85].
An official website of the United States government
Home