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Report Produced: 05/01/2025 02:08 AM

Report Question ID Question Discussion Answer Year
20031153 Laterality/Multiple Primaries (Pre-2007)--Ovary: Are ovarian primaries with bilateral involvement always coded to laterality 4 (bilateral)? See Description. Example: "Right ovary with mass replacing majority of ovarian tissue consistent with serous adenoca. Lt ovary with foci of adenoca." No specific statement of primary. Can we assume that the malignancy originated in the right ovary since it is more extensively involved or should laterality be coded 4 because both ovaries have tumor?

For tumors diagnosed prior to 2007:

If one ovary is listed as the primary site, code laterality to that ovary. The example above is one of those times when you would code to the single ovary. The issue of one or both ovaries being involved is handled in staging.

Abstract the example above as a single primary with code 1 [Right] for laterality.

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
20031128 Histology (Pre-2007): What code is used to represent the histology "PD infiltrating duct ca with focal sarcomatoid pleomorphic features?"

For tumors diagnosed prior to 2007:

Code histology as 8500/33 [Infiltrating duct carcinoma, poorly differentiated]. "Features" is a term from the list indicating a majority of the tumor, however; in this case "features" is modified by "focal" which does not indicate a majority of the tumor.

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
20031127 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: Would the simultaneously occurring histologies of "high grade ductal carcinoma in situ with micro invasion" and "keratinizing squamous cell carcinoma" be coded as two primaries or as a single primary when the pathologist is not clear whether two separate tumor masses exist?

For tumors diagnosed prior to 2007:

Code as two primaries, assuming the tumors are separate and the margins are clear/negative. Code 8071/3 [Invasive squamous cell ca, keratinizing] and 8500/3 [Ductal carcinoma, "microinvasive"].

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
20031156 Histology (Pre-2007)--Ovary: Should the histology "endometroid adenocarcinoma arising in a serous fibroadenoma" be coded to 8380 [Endometroid adenocarcinoma, NOS] or 9014 [Malignant serous fibroadenoma]?

For tumors diagnosed prior to 2007:

The best code is 8381/3 [Endometroid adenofibroma, malignant]. According to our pathologist consultant: "Serous 'fibroadenoma' is not exactly standard terminology. I would guess the pathologist is looking at an adenofibroma with more fibro and less adeno and thus has changed the terminology around. The combination of the benign serous and malignant edometrioid is also a bit unusual. Each of the proposed codes is defendable, but I prefer endometrioid adenofibroma, 8381/3, because it puts the tumor in the adenofibroma category (less common) yet still identifies the malignant element (endometrioid), even though it does lose the serous. But anyone wanting to look at malignant adenofibromas would find the case, and we would carry it under the appropriate malignant component."

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
20031200 Reportability/Terminology, NOS--Hematopoietic, NOS: Is "smoldering" multiple myeloma reportable to SEER?

For cases diagnosed prior to 1/1/2010:Yes, "smoldering" multiple myeloma is reportable to SEER as multiple myeloma [9732/3].

According to our pathologist consultant, "smoldering" multiple myeloma would certainly refer to a diagnosed process. Smoldering means the process is progressing, but perhaps slowly, or even at a slower pace than might be expected.

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.

 2003
20031125

Histology/Reportability/Behavior Code--Testis: Is a mature teratoma that is metastatic to lymph nodes reportable? See Description.

Pathology report states, "Histologic sections reveal lymph node metastases, consisting predominantly of mature teratoma. In addition, there are cells scattered through the fibrous stroma which exhibit mild cytologic atypia but have low N:C ratios. The largest metastasis grossly measures 10cm. In addition extracapsular extension is identified. Diagnosis: Lymph Nodes--Metastatic Testicular Carcinoma Involving Multiple Lymph Nodes." The morphology code for mature teratoma is 9080/0. The pathologist does not classify this as an immature teratoma (9080/3). Is this reportable?

Yes, this metastatic teratoma is reportable.

This is a malignant teratoma by virtue of the lymph node metastases. Code the histology as 9080/3 [Teratoma, malignant, NOS]. Primary site is testis [C62_].

 2003
20031124 Multiple Primaries (Pre-2007)--Breast: Synchronous invasive right breast tumors. Ductal carcinoma, NOS in UIQ and Ductal carcinoma, tubular type in LOQ. Are these two primaries or a single primary coded to 8523/3?

For tumors diagnosed prior to 2007:

Code as two primaries, one 8500/3 [Infiltrating duct carcinoma] and one 8211/3 [Tubular carcinoma].

Apply the multiple primary rules first. These are synchronous right breast tumors with different histologies. Therefore, they are separate primaries according to rule 5.a on page 12 of the SEER Program Code Manual. ICD-O-3 histology code 8523/3 is NOT to be used to combine histologies from separate primaries; it is used for mixed histologies in a single 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.

 2003
20031203 Surgery of Primary Site--Skin: Should this field be coded to 45 [wide excision or reexcision of lesion or minor (local) amputation with margins more than 1 cm, NOS], 46 [with margins between 1 and 2 cm], or 47 [with margins greater than 2 cm] for a skin primary diagnosed in 2003 when margins are stated exactly as 2 cm? Use code 46 [Wide excision...with margins more than 1 cm and less than 2 cm] when margins are exactly 2 cm. 2003
20031075 EOD-Extension--Colon: How should this field be coded for "adenocarcinoma penetrating through bowel wall into adjacent adipose tissue? For cases diagnosed 1998-2003: The difference between EOD-extension codes 40 and 45 is the level of the fat involved. Code 40 is subserosal fat immediately adjacent to the muscular wall of the colon inside the serosa/visceral peritoneum. Code 45 is pericolic fat in areas where there is a serosal surface or in the retroperitoneal areas of the ascending and descending colon where there is no serosa. Code 42 was added for use when it is not possible to determine whether subserosal fat or pericolic fat is involved. Code 42 should be used only when there is a reference to 'fat' (NOS) The answer for the case example above depends on the location of the primary and whether the fat referred to is within or outside the entire thickness of the colon wall. If no additional information is available, use code 42 [Fat, NOS]. 2003
20031068

EOD-Extension--Colon: Is a pathology description of "superficial invasion of the muscularis mucosa in the upper stalk of the polyp" coded in this field to 10 [mucosa (including intramucosal) NOS], 12 [Muscularis mucosa], or 14 [Stalk of polyp]? See Description.

Do we use the highest applicable value because all three definitions are used in the following example? Ex: Path diagnosis: Sigmoid polyp: tubulovillous adenoma with a focus within upper portion of stalk consistent with superficially invasive (intramucosal) colonic adenocarcinoma (see Comment). Comment: ... in the upper stalk region, there is evidence of superficially invasive carcinoma which appears to be limited to the muscularis mucosa and thus would be intramucosal by classification.

For cases diagnosed 1998-2003: Code extension as 12 [muscularis mucosae]. For this case, "upper stalk" is a reference to location rather than extension. This adenocarcinoma extends to the muscularis mucosa.

 2003