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Report Produced: 02/16/2026 17:20 PM

Report Question ID Question Discussion Answer Year
20041026 CS Tumor Size--Ovary: The size of a cyst is not coded in this field. However, can the size of a "cystic mass" be coded in this field? See Discussion. The specimen consists of a cystic mass which weighs 1520 grams and measures 23 x 17 x 10 cm.

If the tumor is described as a "cystic mass" and only the size of the entire mass is given, code the size of the entire mass, because the cysts are part of the tumor itself.

Please note: Ovarian cancer stage is not based on tumor size.

 2004
20041051 First Course Treatment/Immunotherapy--Colon: Can "Sandostatin" be coded for treatment of carcinoid tumors of the colon because it flushes tumor cells from the colon in addition to controlling diarrhea? Do not code Sandostatin (Ocreotide Acetate) as treatment. This is an ancillary drug used to treat symptoms of diarrhea. SEER Book 8 is undergoing revision and will include this change. 2004
20041010 Multiple Primaries--Lymphoma: How many primaries should we abstract when Single Versus Subsequent Primaries table indicates one primary but special pathological studies indicate two primaries? See Description. The patient had a malignant lymphoma, large B cell (9680) diagnosed in 2000. In 2003, he came in and had a spleen biopsy which showed follicular lymphoma (9690). These are the same NHL, according to the table lookup. However, the pathologist states in 2003, "Special stains now show a kappa clonal lymphoma. Since the first diagnosis was a lambda monoclonal lymphoma, this is not felt to be a recurrence of the original lymphoma."

For cases diagnosed prior to 1/1/2010:Abstract the example above as two primaries. Hematologic malignancies (including lymphoma) and solid tumors are handled differently when determining the number of primaries. For hematologic malignancies, take the physician's opinion into account. Use the Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table as an aid when there is insufficient information available.

For solid tumors, follow the multiple primary rules in the SEER Program Code Manual.

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.

 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
20041025 Immunotherapy/Chemotherapy: Are monoclonal antibodies, such as Avastin and Erbitux, coded as immunotherapy or chemotherapy? See Discussion. In review of the "FDA-approved oncology agents not listed in SEER Book 8" provided in 5/02, it appears "monoclonal antibodies" are coded as immunotherapy. Code Avastin and Erbitux as chemotherapy because both of these drugs are growth inhibitors. Code growth inhibitors (cytostatic agents) as chemotherapy. Do not assume that monoclonal antibodies are coded as immunotherapy. 2004
20041088 CS Extension/EOD Extension--Renal Pelvis: Primary site is renal pelvis with direct extension to the rt adrenal gland. What is the correct extension code?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Assign CS Extension code 67 [Adrenal gland from renal pelvis] for adrenal extension from renal pelvis -- T4 and regional direct extension.

 2004
20041104 Histology (Pre-2007)--Bladder: What is the correct histology code for this tumor of the bladder? See Discussion. TURBT was performed with invasive residual tumor remaining - path report reads "Mixed carcinoma of the urinary bladder, with components of invasive high grade urothelial carcinoma, invading deep muscle, and small cell carcinoma."

For tumors diagnosed prior to 2007:

Code combined small cell carcinoma [8045]. This mixed carcinoma is both urothelial and small cell. It is important to capture the small cell information in the code because the prognosis for small cell is different from pure urothelial carcinoma.

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
20041067 Histology (Pre-2007)--Lung: Does 8070 [squamous cell carcinoma], 8560 [adenosquamous carcinoma] or 8255 [adenocarcinoma with mixed subtypes] best represent this field for a lung biopsy described as a "poorly differentiated non-small cell carcinoma with squamous and glandular features with focal mucin positivity per mucin stain"?

For tumors diagnosed prior to 2007:

Assign code 8560/33 [Adenosquamous carcinoma, poorly differentiated]. "Glandular" carcinoma is a synonym for adenocarcinoma. Mixed adenocarcinoma and squamous carcinoma is coded to 8560. Do not use code 8255 [Adenocarcinoma with mixed subtypes] when a more specific complex code is available.

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
20041055 Primary Site/Grade, Differentiation, Cell indicator--Lymphoma: Will a Grade, Differentiation code of 6 [B-cell] for a lymphoma coded to primary site C80.9 [unknown] fail edits? See Discussion. Patient had a large mass in chest wall that was excised and found to be large B cell lymphoma. Scans mentioned no involvement of lymph nodes but indicated nodules in the liver thought to be lymphoma as well.

For cases diagnosed prior to 1/1/2010:The combination of a primary site C809 with a Grade, Differentiation code of 6 when used for a lymphoma will not fail SEER edits. Avoid coding primary site to C809 when possible. Code primary site for the example above to C761 [Chest wall, NOS]. The chest wall is the only area of involvement, except for "liver nodules." Liver is an unlikely primary site for lymphoma.

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.

 2004
20041086 Histology (Pre-2007)/CS Tumor Size/CS Extension--Colon: How are these fields coded if a 3 cm sessile polyp is snared and removed piecemeal during a colonoscopy and the path microscopic description indicates a polypoid lesion with foci of malignant transformation found associated with bundles of smooth muscles followed by a LAR with no residual invasive tumor but the final path diagnosis is stated to be a M.D. adenocarcinoma? See Discussion.

3/04 colonoscopy 3cm sessile polyp snared & removed piecemeal. Path Micro: Polypoid lesion consists of branching & complex neoplastic glands lined by tall columnar epithelial...These foci of malignant transformation are assoicated with large polygonal epithelial...associated with desmoplastic stromal reaction & neoplastic glands can be found associated with bundles of smooth muscle.

4/04 LAR: focus of residual HG dysplasia: no residual invasive tumor. Final path dx: MD adenocarcinoma. Physician staged: T2 N0 M0.

Histology: 8140 vs 8210

Tumor Size: 030 vs 999 vs 990

Extension: 12 vs 20

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

For tumors diagnosed prior to 2007:

Based only on information provided:

Histology: 8210 [Adenocarcinoma in a polyp]

Tumor Size: 999 [Unknown]

CS Extension: 20 [Muscularis propria invaded]

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