Report | Question ID | Question | Discussion | Answer | Year |
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20051133 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How are the number of primaries, histologies and CS extension fields coded for breast tissue that contains separate areas of invasive ductal carcinoma, intraductal carcinoma and Paget disease? See Discussion. | Excisional biopsy of a breast mass: 1.0 cm tumor that was infiltrating ductal carcinoma, high grade, with an associated intraductal component with comedonecrosis. Pathology report for the mastectomy three weeks later: no residual tumor was found near the original biopsy site. In another portion of the same breast was found high-grade intraductal carcinoma involving the nipple ducts, with Paget Disease of the nipple. (No size was given for this.) |
For tumors diagnosed prior to 2007:
This is a single primary. According to Exception 3 of Multiple Primary Rule 6 for multiple tumors, combinations of Paget disease and ductal carcinoma are a single primary. The histology code for this case is 8541 [Paget disease and infiltrating duct carcinoma]. Assign CS extension code 10 [confined to breast tissue] based on the information above.
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. |
2005 |
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20051110 | Other Therapy: Can herbal therapy be coded when used as a single therapy or when used in combination with conventional therapy as a complimentary treatment? See Discussion. | Page 201 of the SPCM 2004, item #5, states "Assign code 6 for unconventional methods whether they are single therapy or given in combination with conventional therapy." This statement itself is ok but there is no guideline on the use of complementary therapy when it is given as the only treatment. The SPCM, 3rd editon, page 140 states: "Use code '6' for alternative and complementary therapies ONLY IF the patient receives no other type of treatment." There is no such statement in the SPCM 2004. | Assign code 6 for unconventional methods whether they are single therapy (alternative medicine is the only treatment) or given in combination with conventional therapy (complementary medicine plus conventional). | 2005 |
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20051028 | Date of Diagnosis--Bladder: Should the date of diagnosis be based on the 1/7/04 urine cytology with low grade transitional cell carcinoma or the subsequent 1/27/04 pathology findings of papillary transitional cell carcinoma? | In this case, the date of the cytology is the date of diagnosis, 01-07-2004. | 2005 | |
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20051002 | CS Tumor Size/CS Site Specific Factor 6--Breast: How are these fields coded for a tumor stated to have only in situ disease in the breast with bone metastasis identified on scan? See Discussion. | 4/20/04 Quadrantectomy: "Tumor involves a significant portion of the biopsy and is estimated at 10 cm in greatest dimension." The only other mention of size is from imaging studies which is 3.5 cm. The histology is "high grade ductal carcinoma with comedo necrosis. No invasive carcinoma identified." Bone scan on 4/20/04 shows "widespread metastatic disease to bone." By rule the behavior code for this case is changed to malignant. | 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. Code tumor size as 100 [10 cm]. Size from pathology or operative report is preferred over size from imaging.
Code SSF6 as 050 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated and proportions of in situ and invasive not known.]
There is invasive tumor present (as proven by the bone metastasis), but the size and proportion of the invasive component is unknown.
Please note: Extension must be coded at least to 10 [Confined to the breast tissue and fat including nipple and areola; Localized, NOS] in this case. Do not assign extension code 00 [in situ]. |
2005 |
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20051053 | Reportability/Multiple Primaries (Pre-2007)/Histology--Anus: How many primaries exist if an 11/7/03 anal lesion presents with poorly differentiated adenocarcinoma with signet ring features and extensive mucin production and the 1/9/04 wide excision has adenocarcinoma and Paget disease (intraepidermal adenocarcinoma) extends to skin margin? | For tumors diagnosed prior to 2007:
This is a single primary: the adenocarcinoma with the Paget representing intraepithelial extension of the process. Tumor cells can invade from their place in the epithelium into the underlying stroma either at the primary site, or at their extension site (skin).
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. |
2005 | |
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20051033 | CS Site Specific Factor--Melanoma: What is the correct code for measured thickness in SSF 1 for a melanoma of the choroid without an enucleation? See Discussion. | CS Site Specific Factor 1 for melanoma of the choroid codes "Measured Thickness (Depth), Breslow's Measurement." The note for this field states "Record actual measurement in millimeters from the pathology report." For melanoma of the eye, there is often only an eye exam report stating the thickness. Can PE thickness (clinical statement only) be coded for SSF 1 or is this field coded only from pathology? (i.e., all cases treated without enucleation would have this field coded to 999) | 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. Code SSF 1 999 [Unknown] when there is no enucleation, and therefore, no pathology report for a choroid melanoma. |
2005 |
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20051144 | CS Lymph Nodes: Are lymphatic channels/vessels within an organ coded as regional lymph nodes? | 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.Lymphatic channels/vessels carry lymph fluid throughout the organs and tissues of the body. Lymph channels/vessels within an organ are not nodes. Lymph channels/vessels outside an organ are not nodes. |
2005 | |
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20051113 | Histology (Pre-2007): What is the difference between code 8244/3 composite carcinoid (combined carcinoid and adenocarcinoma) and 8245/3 adenocarcinoid tumor? | For tumors diagnosed prior to 2007:
Assign code 8244/3 [composite carcinoid] when there is a combination of adenocarcinoma and carcinoid tumor. Assign code 8245/3 [adenocarcinoid] when the diagnosis is exactly "adenocarcinoid."
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. |
2005 | |
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20051032 | Reportability/Behavior--Brain and CNS: How is a brain "neoplasm" diagnosed only by CT scan reported to SEER? See Discussion. | We have a significant number of patients who come into our emergency room and are diagnosed with a brain neoplasm by CT scan. They are transferred to another facility for further care. Some of those facilities will give us information - histology, treatment, etc. Some will not. How are we supposed to report these brain neoplasms if we don't know if they are benign or malignant? Can we report them as behavior code 9 or do we just report them as benign if we can't get any further information? | The case above is reportable and 8000/1 is the most appropriate histology/behavior code. A clinical diagnosis alone from diagnostic imaging reporting a brain 'neoplasm' (with a diagnosis date supporting the reportable case requirements) even with no other information available (from biopsy or resection) is reportable. Care should be taken when reviewing terms used by the radiologist on these reports, since some tumors exhibit defining characteristics that can be picked up on diagnostic imaging. | 2005 |
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20051127 | Reportability--Brain and CNS: Is an "intradural extramedullary schwannoma (neurilemoma)" of the spine reportable? See Discussion. | Example: Pt underwent laminectomy and excision of intradural extramedullary tumor. Is there a default decision for tumors described as intradural extramedullary tumors, NOS? |
For cases diagnosed 2011 and later: A spinal "intradural extramedullary schwannoma (neurilemoma)" is reportable. This schwannoma originated in the spinal nerve root, C720.
See #2 under Reportability in the Data Collection Answers from the CoC, NPCR, SEER Technical Workgroup, http://www.seer.cancer.gov/registrars/data-collection.html#reportability |
2005 |