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Report Produced: 05/24/2026 17:56 PM

Report Question ID Question Discussion Answer Year
20041100 Sequence Number-central/Multiple Primaries (Pre-2007): What criteria are to be used to determine which primary site carries a worse prognosis? Should we take survival into consideration? See Discussion.

In the case of two or more simultaneously diagnosed primary tumors, instructions in the SEER manual state that the tumor with the worse prognosis is to be assigned the lower sequence number. Prognosis decisions should be based on primary site, histology and extent of disease.

Stage as a criteria for decision making is fairly straightforward. On the other hand, decisions based on primary site seem to be more subjective than objective.

For tumors diagnosed prior to 2007:

Compare the combination of the primary site, histology and extent of disease for each primary, and assign the lowest sequence number to the primary with the worst prognosis. Do not use primary site or histology alone to determine prognosis in the case of assigning sequence number. Survival is a component of prognosis.

If there is no difference in prognosis, assign the sequence numbers in any order.

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
20041029

Ambiguous Terminology/Reportability: Are the terms "bordering on" and "may represent" diagnostic of cancer? See Discussion.

Pathology report states "...florid micropapillary hyperplasia, focally atypical with features bordering on low grade micropapillary ductal carcinoma in situ."

The terms "bordering on" and "may represent" are not diagnostic of cancer. These terms are not on the list of ambiguous terms that constitute a diagnosis of cancer. The diagnosis in the example above is not reportable to SEER.

 2004
20041097

Reportability--Brain and CNS: Is a skull tumor schwannoma an intracranial reportable benign tumor if the physician states it arose in the occipital nerve?

No. These schwannomas are not intracranial and therefore, are not reportable to SEER. The occipital nerve is not one of the 12 intracranial nerves (i.e., Abducens, Auditory (vestibulocochlear), Facial, Glossopharyngeal, Hypoglossal, Oculomotor, Olfactory, Optic, Spinal Accessory, Trigeminal, Trochlear, and Vagus).

 2004
20041089

Reportablility--Breast: Is lobular neoplasia, grade 2 reportable? See Discussion.

Path report reads: Lobular neoplasia, grade 2.

According to the AFIP nomenclature for DCIS (taken from the WHO terminology), this would be the equivalent of LCIS. But nowhere can I find this specifically applies to lobular in the same way that ductal neoplasia is treated.

According to the editors of ICD-O-3, lobular neoplasia grade 2 is not equivalent to LCIS. It is not a reportable term. Lobular neoplasia and lobular intraepithelial neoplasia are equivalent terms having a three grade system. Only LN/LIN grade 3 would be reportable since those terms are analogous to ductal intraepithelial neoplasia grade 3.

2004
20041071 Histology (Pre-2007)--Breast: When the histology from a lumpectomy differs from that of a core needle biopsy, should the lumpectomy histology be coded? See Discussion.

Histology - Page 85 of the SPM 2004, Histology Type Coding Instructions, #2. Use the histology stated in the final diagnosis from the pathology report. Use the pathology from the procedure that resected the majority of the primary tumor.

Based on this rule, should the following case should be coded to Ductal Carcinoma (8500/31)?

Core needle bx: WD Infiltrating Ductal Carcinoma with focal lobular features. Lumpectomy: WD Invasive Ductal Carcinoma.

For tumors diagnosed prior to 2007:

Yes, code this case to 8500/31 [Well differentiated invasive ductal carcinoma]. Code the histology stated on the pathology report from the procedure removing the most tumor tissue. A lumpectomy will usually provide more tumor tissue than a core needle biopsy.

First, determine which specimen contains the most TUMOR tissue -- in this case the lumpectomy. Next, apply the histology coding rules to the diagnosis on that pathology report. The rationale is that a diagnosis from a smaller specimen will be less accurate and less representative of the true histology compared to a larger tumor specimen.

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
20041022 Primary site/Histology (Pre-2007)/Behavior: What is the correct site and histology/behavior for the following diagnosis: "mucinous cystadenoma of the appendix with perforation and pseudomyxoma peritonei." This was diagnosed at e-lap for a separate adenocarcinoma of the ascending colon.

For tumors diagnosed prior to 2007:

The appropriate code for mucinous cystadenoma of the appendix with perforation and pseudomyxoma peritonei is C18.1 8470/0. It is not reportable to SEER. According to our pathologist consultant, mucinous cystadenoma is a legitimate term for such appendiceal tumors. They may implant all over the peritoneum as pseudomyxoma peritonei, especially in the face of perforation, without being histologically malignant.

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
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
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
20041017 EOD-Lymph Nodes--Breast: When isolated tumor cells are found in an axillary lymph node, should lymph node involvement be coded to 0 [no lymph node involvement] or 1 [micrometastasis (less than or equal to 0.2 cm)]? For cases diagnosed prior to 2004: Code the EOD-Lymph Node field to 0 [No lymph node involvement] when regional lymph nodes are negative, even if there are positive isolated tumor cells (ITC). 2004
20041082 Date of Diagnosis: When a 4/04 clinical impression indicates the appearance of a carcinoma that is contradicted by a negative 4/04 biopsy but is confirmed by a 5/04 resection, should the diagnosis date be coded to April or May? See Discussion.

4/04 colonscopy: irregular fungating mass that has appearance of carcinoma. 4/04 Bx: high grade dysplasia. 5/04: LAR. 5/04 Path: 3.2 X 2.5 cm mass wd adenoca with invasion of muscularis propria.

Should the diagnosis date be 4/04 based on the clinical impression during the colonoscopy OR 5/04 since the path for the bx was negative?

 The date of diagnosis for the example above is 05/04 -- the date of the pathology report confirming malignacy. The biopsy in 04/04 negated the 04/04 clinical statement. 2004