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Report Produced: 05/24/2026 20:35 PM

Report Question ID Question Discussion Answer Year
20041098 Histology--Prostate: We are seeing numerous pathology reports with the following diagnosis: "Conventional (acinar) prostatic adenocarcinoma (M81403)." What is the correct histology code? For cases diagnosed prior to January 1, 2007, assign histology code 8550/3 [Acinar adenocarcinoma]. 2004
20041065 Date Therapy Initiated/First-Course of Cancer-Directed Therapy Fields/Summary Stage 2000--Prostate: How do you code these fields for a case that received preventative chemo before a definitive cancer diagnosis? A patient has a "suspicious but not diagnostic" biopsy of the prostate in 09/2002. Doctor said it was not cancer and put the patient on a preventative chemo drug study (GTX-211). The patient returned for a repeat biopsy on 04/2003. Biopsy returned positive for adenocarcinoma. The patient had not been diagnosed when chemo was administered. Can the case be staged using the post-chemo information?

Stage this case the same as all other cases. Use only the information subsequent to the date of diagnosis to code stage and treatment.

The diagnosis date in the example is 04/2003. Do not use information prior to 04/2003 to code stage or treatment. Do not code the preventative chemo as treatment.

 2004
20041078

Ambiguous Terminology: Is the expression "has the markings of a malignancy" a clinically reportable term? See Discussion.

12/02 Baseline mammogram: spiculated mass with associated marked retraction located in UOQ lt breast. This has the markings of malignancy. Several microcalcifications in outer aspect of rt breast. BI-RADS 5 higly suggestive of malignancy.

Do not accession cases using only the term "has the markings of malignancy." This term is not on the list of ambiguous terms that are reportable. If the term does not appear on either the reportable or not reportable list, the term is not diagnostic of cancer. Do not accession the case.

Please see SINQ 20010094 in reference to BI-RADS terminology.

 2004
20041072 Histology (Pre-2007)--Colon: Must a case be specifically labeled "familial adenomatous polyposis" or is the mere presence of numerous/multiple polyps sufficient for coding the histology to FAP?

For tumors diagnosed prior to 2007:

The presence of numerous/multiple polyps is not necessarily adenomatous polyposis coli. Adenomatous polyposis is an extreme condition usually characterized by the presence of hundreds of polyps and should be identified as such either clinically or pathologically.

Look for the term "Familial adenomatous polyposis," FAP or one of its synonyms:

Adenomatosis of the colon and rectum [ACR]

Familial adenomatous colon polyposis

Familial colonic polyposis

Multiple familial polyposis

In the absence of these terms, the following probably indicate a diagnosis of FAP:

Hundreds of adenomatous polyps throughout large intestines, and at times, throughout the digestive system

Development of polyps as early as ten years of age, but more commonly at puberty

History of colectomy

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.

 2004
20041093 Reportability: When a biopsy is suspicious for cancer and re-biopsy is negative, is reportability based on the clinician's judgement (cancer vs NED)? If the re-biopsy was done because the first biopsy was inconclusive, do not report this case. If the re-biopsy was more complete, or performed in an attempt to gain a wider margin, this case is reportable based on the first biopsy. 2004
20041069

Reportability--Brain and CNS: Is a meningioma invading the bone malignant and, therefore, SEER reportable if diagnosed prior to 2004? See Discussion.

1. Meningothelial meningioma with prominent nuclear pleomorphism, infiltration into dura, calvarium, temporalis skeletal muscle.

Microscopic: Multifocal infiltration by meningothelial tumor...extensive infiltration of trabecular spaces, extension through inner and outer calvarial layers by meningioma...mitotic activity in tumor noted but below the 4 per 10 high power field threshold for diagnosis of atypical meningioma.

2. Aggressive (invasive) transitional type meningioma, neuroimaging and histology imply extensive invasive meningioma involving bone and paraspinal soft tissues. Microscopy:...invaded bone...focal EMA positivity diagnostic of invasive transitional type meningioma... tumor invades bone.

The two cases above are benign meningiomas and not reportable prior to 2004. According to an expert consultant, meningiomas are in the lining cells for the inner table of the skull and as such have an affinity for bone that allows them to penetrate adjacent bone without being "malignant."

The WHO Nervous System Tumor Classification states malignant meningioma exibits histological features of frank malignancy far in excess of the abnormalities present in atypical meningioma (WHO grade II). Examples of the histologic features of malignant meningioma are obviously malignant cytology, or high mitotic index (20 or more mitoses per 10 high-power fields). They correspond to WHO grade III and are usually fatal.

 2004
20041023 Histology (Pre-2007)--Lung: Should "moderately differentiated adenocarcinoma of scar type, intermixed with bronchiolo-alveolar carcinoma" be coded to 8250 [bronchiolo-alveolar adenocarcinoma, NOS] or 8255 [adenocarcinoma of mixed subtypes]?

For tumors diagnosed prior to 2007:

Code Histology to 8255 [Adenocarcinoma with mixed subtypes]. This is a single tumor containing both a scar carcinoma and a bronchiolo-alveolar carcinoma--use 8255. The synonym for 8255 is adenocarcinoma combined with other types of carcinoma (not just subtypes).

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.

 2004
20041063 Primary Site/Histology (Pre-2007)--Mediastinum: How do we code these fields for a case described as a "neuroendocrine carcinoma" of the "anterior mediastinum" without failing the SEER "impossible" site/histology combination edit? See Discussion. Two different facilities state that the patient has "neuroendocrine carcinoma of the anterior mediastinum." This coded combination failed SEER edit (SEERIF38). We can not correct it because that edit flag does not appear on our system. Both facilities indicate that the mediastinum is the primary. In addition, there is text to support both the histology and primary site codes.

For tumors diagnosed prior to 2007:

The combination of C381 [anterior mediastinum] and 8246 [neuroendocrine carcinoma] will be removed from the list of "impossible" site/histology combinations. There are rare cases of neuroendocrine carcinoma of the anterior mediastinum. As illustrated in the discussion, verify that the primary site is anterior mediastinum, the histology is neuroendocrine ca, and document those findings in the text.

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.

 2004
20041062 Histology (Pre-2007): Can we ever code this field using a more specific cell type from a metastatic site specimen rather than to a less specific cell type from the primary site specimen? See Discussion. The histology for a metastatic deposit biopsy is mucin-producing adenocarcinoma. This report states that the primary site is the stomach. It is more specific than the histology from the stomach biopsy described as adenocarcinoma, NOS.

For tumors diagnosed prior to 2007:

Code the histology for the case example to 8481/3 [mucin-producing adenocarcinoma], the more specific histology.

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.

 2004
20041050 Surgery of Primary Site--Rectum: How do you code a procedure described as a "transanal resection, debulking of a large rectal mass"? See Discussion. Patient is not a surgical candidate due to "other medical conditions". Colonoscopy done for anemia and rectal bleeding. At the colonoscopy a "Transanal Resection Debulking of large rectal mass" is performed. Two specimens are sent to the lab. The first is labeled "rectal mass" and is a 2.0 cm diameter spherical fragment of tissue. The second is labeled "transanal debulking rectal mass" and is described as multiple, irregular shaped fragments of tan, rubbery tissue measuring 5.0 x 5.0 x 3.0 cm. Final path diagnosis: Debulking of rectal mass: Adenocarcinoma greater than 2 cm in size, resection margins positive for tumor. For cases diagnosed 1998-2002, code Surgery of Primary Site to 20 [Local tumor excision, NOS]. Because the procedure was performed via colonoscopy and apparently did not involve proctectomy, the best choice is a local excision. 2004