EOD-Extension--Stomach: How is this field coded for a stomach primary that has metastases to "Sister Mary Joseph's Nodes?"
For cases diagnosed 1998-2003: For a stomach primary, code extension to 70 [Abdominal wall]. Sister Mary Joseph's nodule is a cutaneous umbilical metastasis most commonly from an intra-abdominal primary.
This rare form of cutaneous umbilical metastasis results from spread of tumor within the falciform ligament. The umbilicus is part of the abdominal wall.
First Course Treatment/Radiation Therapy/Immunotherapy--Thyroid: For this primary, do we code I-131 as a Radio-isotope as well as a Biological Response Modifier? See Description.
(SEER Book 8 lists I-131 as a Biological Response Modifier.) Immunoglobulin is listed as immunotherapy agent in the CCR manual also coded as immunotherapy. Are there two different types of I-131, immunoglobulin and sodium iodide?
Sodium Iodide is listed as an ancillary drug in SEER Book 8, page 45. The listing on page 63 refers to Antiferritin antibody, or AntiCEA. Both of these were under clinical investigation when Book 8 was written. They are no longer active and this change will be made when Book 8 is revised.
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-Clinical Extension--Prostate: How is this field coded when biopsies of the prostatic apex are positive and the physician clinically stages the case as T1c?
For cases diagnosed 1998-2003:
Code clinical extension to 33 [arising in the prostatic apex] when a biopsy of the prostatic apex is positive for malignancy, with no further evidence of involvement. If biopsies of both the apex and another site within the prostate (for example right lobe) are positive and there is no mention that the malignancy arose in the apex, code extension to 34 [extending into the prostatic apex].
EOD-Extension--Colon: How is this field coded for an appendical primary when the appendix has ruptured and intrapentoneal fluid is positive?
For cases diagnosed 1998-2003: Code EOD extension as 85 [Metastasis]. Positive intraperitoneal fluid is equivalent to distant metastasis (implantation) for colon, including appendix, primaries.
Primary Site--Melanoma: How would this field be coded for a pleural effusion consistent with metastatic melanoma and "no skin lesions?"
Code primary site as C44.9 [Skin, NOS]. ICD-O-3 does not list a suggested site code for 8720/3 because melanoma can arise in other parts of the body. However, C44.9 [Skin, NOS] is the default when the primary cannot be found.
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--Head & Neck: Is this field coded 10 [Invasive tumor confined to one of the following subsites: interior wall, one lateral wall, posterior wall] or 30 [Localized, NOS] for tonsillar primary when there is no mention of involvement of surrounding structures? See Description.
Site is stated to be "left tonsil" and was coded to site C099. "The lesion is admixed in tonsillar tissue." No surrounding structures are stated to be involved. Is it logical to assume that since code C099 includes the palantine tonsils and the palatine tonsils are on the lateral wall and since no other areas are stated to be involved that extension code 10 [confined to one lateral wall] would be more appropriate than code 30 [localized NOS]?
For cases diagnosed 1998-2003: Code EOD-extension for the case example to 10 [Invasive tumor confined to one of the following subsites: anterior wall, one lateral wall, posterior wall]. The tonsil lies in a pocket on the wall (tonsillar fossa), so you know it is confined to the wall.
Histology (Pre-2007)--Breast: Should the histology "non-invasive papillary carcinoma" along with the comment "solid intraductal papillary proliferation includes cytologically atypical cells with scattered mitotic figures" be coded to 8503/2 [intraductal papillary carcinoma] or 8050/2 [papillary carcinoma in situ]?
For tumors diagnosed prior to 2007:
The best histology code for this breast case is 8503/2 [Noninfiltrating intraductal papillary carcinoma]. According to the WHO Classification of Tumors for Breast, Papillary carcinoma, non-invasive is a synonym for Intraductal papillary carcinoma. Further, code a more specific histologic type when found in the microscopic description, according to the SEER Program Code manual.
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.
Reportability/Terminology, NOS--Hematopoietic, NOS: Are the diagnoses "myelodysplastic syndrome," "myelodysplastic syndrome, thrombocytopenia" and "myelodysplastic syndrome, anemia" all reportable to SEER for diagnosis 2001 and later?
For cases diagnosed prior to 1/1/2010:"Myelodysplastic syndrome" (NOS) is reportable to SEER--ICD-O-3 code 9989/3. "Myelodysplastic syndrome, thrombocytopenia" is not reportable to SEER because "thrombocytopenia" is not reportable. "Myelodysplastic syndrome, anemia" is not reportable to SEER because "anemia" is not reportable.
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.
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