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Report Produced: 09/17/2026 12:25 PM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20061042 First Course Treatment--Lymphoma: Should the use of proton pump inhibitors be coded as treatment for lymphoma primaries in patients with H Pylori? No, do not code proton pump inhibitors as treatment. These are used for gastric acid suppression. Proton pump inhibitors are used to treat symptoms, not the lymphoma itself. Lymphoma First course treatment 2006
20061024 Histology (Pre-2007)--Kidney: How is a "mucinous tubular and spindle cell carcinoma" coded? See Discussion. Literature search results: "The new WHO-classification of renal tumors includes new subtypes, one of which is the mucinous, tubular, and spindle cell carcinoma. Many of these tumors had been previously diagnosed as sarcomatoid carcinoma. There are areas of cord-like growth and spindle cell configuration, sometimes with a clear cell appearance."

For tumors diagnosed prior to 2007:

Code histology to 8255 [Adenocarcinoma with mixed subtypes]. ICD-O-3 does not have a code specific to this combination histology. 8255 is the best code 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.

 Kidney, renal pelvis Histology 2006
20061025 Histology--Hematopoietic, NOS: How is an "advanced MDS (RAEB-T)/emerging AML" coded when discovered on a bone marrow biopsy?

For cases diagnosed prior to 1/1/2010:Code histology to 9984/3 [RAEB-T]. This particular MDS is refractory anemia with excess blasts in transformation. It has not yet progressed to acute myeloid leukemia.

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.

 N/A Histology 2006
20061129 Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are abstracted if a patient has bilateral involvement of tonsils with the same histology (e.g. squamous cell carcinoma)? See Discussion. Patient was initially found to have mass on right tonsil. Biopsy of right tonsil on June 16 showed invasive carcinoma, favor squamous cell. On July 17 patient underwent right neck dissection, radical resection of right tonsil tumor and left tonsillectomy. Right tonsil showed squamous cell carcinoma, poorly differentiated. Left tonsil showed squamous cell carcinoma, poorly differentiated. Microscopic report stated: Right tonsil: Invasion of deep peritonsillar tissue and skeletal muscle. Sections of left tonsil demonstrate squamous cell ca focally distributed in the tonsil, predominantly in situ, but with focal microscopic invasion. Path staged each tonsil specimen. Right tonsil was T2N1. Left tonsil was T1Nx.

For tumors diagnosed prior to 2007:

Code as two primaries. Squamous cell carcinoma diagnosed in both left and right tonsils are multiple primaries unless one is stated to be metastatic from the other.

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.

 Head & Neck N/A 2006
20061135 Reportability--Hematopoietic, NOS: Is a "refractory cytopenia with excess blasts" discovered on a bone marrow biopsy reportable?

For cases diagnosed prior to 1/1/2010:

Refractory cytopenia with excess blasts (RCEB) is reportable. RCEB is the same disease process as refractory anemia with excess blasts, except there is more than one type of blood cell that is low (red, white, platelets).

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.

 N/A N/A 2006
20061093 Ambiguous Terminology--Breast: Is a stereotactic biopsy that is "focally suspicious for DCIS" reportable if it is followed by a negative excisional biopsy? See Discussion.

Per the 2004 SEER manual page 4, 1.a, the case is reportable based on the ambiguous term "suspicious" for DCIS.

Per the 2004 SEER manual page 4, 1.c, use these terms when screening diagnoses on pathology reports, operative reports, scans, mammograms, and other diagnostic testing other than tumor markers.

Note: If the ambiguous diagnosis is proven to be not reportable by biopsy, cytology, or physician's statement, do not accession the case.

 Do not accession this case. The needle localization excisional biopsy was performed to further evaluate the suspicious finding found on stereotactic biopsy. The suspicious diagnosis was proven to be false. Breast N/A 2006
20061136

Primary Site: What site code best reflects the final diagnosis of a metastatic "pancreatobiliary" adenocarcinoma to the liver? See Discussion.

CT showed multiple masses in the liver and lymphadenopathy in areas of gastrohepatic ligament, celiac axis, superior mesenteric and left periaortic regions. No mention of a mass in pancreas or common duct. When the term "pancreatobiliary" primary is stated in the final diagnosis, what site code should be used?

Contact the physician for clarification of the term "pancreatobiliary." If no further information can be obtained for this case, assign code C249 [Biliary tract, NOS] based on the CT findings for the specific case in this question.

When the primary is described as "pancreatobiliary" with NO FURTHER INFORMATION, assign C269.

 N/A Primary site 2006
20061018 Multiple Primaries (Pre-2007)--Brain and CNS: Is neurofibromatosis a separate and distinct primary in the presence of a longstanding glioma? Does the following show one or two primaries? See Discussion. MRI of Brain: 1. Findings compatible with left optic nerve glioma. 2. Stable enhancing focus in left temporal white matter. Lack of interval change since Dec 2000 suggests a white matter finding typical of neurofibromatosis and makes more aggressive processes such as astrocytoma less likely. Small aneurysm can not be excluded.

For tumors diagnosed prior to 2007:

Neurofibromatosis and glioma would be separate brain/CNS primaries.

However, there is only one primary in the case example above: Glioma, left opic nerve. "...suggests a white matter finding typical of neurofibromatosis" is not reportable. "Suggests" is not a reportable term. Therefore, in this example neurofibromatosis is not reportable unless there is a more definitive statement in the record.

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.

 Brain and CNS N/A 2006
20061113 Histology (Pre-2007)--Melanoma: How is histology coded for a final pathology diagnosis of "malignant melanoma, NOS" that is clinically described as a nevus?

For tumors diagnosed prior to 2007:

Code 8720 [malignant melanoma]. Assign the histology code based on the histology stated in the final diagnosis on the pathology report. The pathology report must say melanoma arising in junctional nevus to use the code 8740/3 [Malignant melanoma in junctional nevus].

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.

Melanoma Histology 2006
20061002 Multiple Primaries (Pre-2007): How many primaries? See Discussion. 5/05 perianal skin bx, 6/05 mapping bx perianal skin, 9/05 punch bx perianal skin: all positive for extramammary Paget Disease. 9/05 Perianal Excision of Paget w/V-Y flap repair. Path: Perianal and anal skin: Extramammary Paget disease associated with: Invasive adenoca of anal canal. Anal margins positive for invasive adenoca. Comment: invasive adenoca with local mucinous features involving the anal margin/end of specimen. This adenoca is in continuity with (associated with) extensively diffuse extramammary Paget disease. Unclear whether the adenoca represents a rectal primary with spread to perianal area, anal gland adenoca or mets. 12/05 AP resection-no residual Paget or invasive neoplasm.

For tumors diagnosed prior to 2007:

There is one primary.

Code the histology to 8542 [Paget disease, extramammary]. Code the primary site C210 [anus]. Histology rule 7 on page 87 of the 2004 SPCM applies in this case.

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.

 N/A N/A 2006