Report | Question ID | Question | Discussion | Answer | Year |
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20061078 | Histology (Pre-2007): How is "adenocarcinoma, diffuse type, with signet ring features" coded? | For tumors diagnosed prior to 2007:
Code 8490 [Signet ring cell carcinoma]. Histology coding Rule 7 is the only rule that applies to this diagnosis. Assign the numerically higher ICD-O-3 code.
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. |
2006 | |
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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. |
2006 |
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20061044 | CS Site Specific Factor--Head & Neck: If a lymph node dissection of the neck reveals that 1/24 lymph nodes is positive and the positive 5.6 cm lymph node extends throughout levels II-IV, how are the SSF 3 (status of levels I-III lymph nodes) and SSF4 (status of levels IV-V lymph nodes) fields coded? | 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.According to the CS Steering Committee, code 999 for SSF 3 and SSF 4. In this case, do not make assumptions about which level of lymph nodes were involved. |
2006 | |
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20061061 | CS Lymph Nodes--Breast: Clarify the use of code 25 [Movable axillary lymph node(s), ipsilateral, positive with more than micrometastasis (i.e., at least one metastasis greater than 2 mm)] vs code 60 [Axillary/regional lymph node(s), NOS; Lymph nodes NOS] when surgically removed lymph nodes are positive but the size of the metastasis is not stated. See Discussion. | Note 2 in CS manual states: "If the pathology report indicates that nodes are positive but size of the metastases is not stated, assume the metastases are greater than 0.2mm and code LNs as positive in this field. Use code 60 in the absence of other information about regional nodes." 1. If the LNs are known to be axillary LNs, note 2 seems to imply the size can be assumed to be greater than 0.2mm. Would you code 25 or 60? 2. Both codes 25 and 60 map to N1, node involvement. Do they each mean something else in the evaluation process? 3. What would constitute "absence of other information"? 4. Is the use of 60 over 25 specific to SEER registries or all users? 5. Abstractors are trained to assume LNs are mobile if there is no contrary information. Is this appropriate? |
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 Lymph Nodes code 25 for breast when there are positive axillary nodes without internal mammary nodes. Code 25 is used in a couple of situations: a. when you know the lymph nodes are clinically movable and only the axillary nodes are involved; b. when you know the size of the metastasis in an axillary lymph node is more than a micrometastasis (i.e., > 2 mm). Code 60 can be used for any regional lymph node (internal mammary, infra- or supraclavicular, as well as axillary. So you can code to 25 if you have "regular" metastases in axillary lymph nodes only. If you don't know whether the mets are micro or regular, use code 60. Assign code 60 when there are positive regional nodes not further described. 1. Assign code 25 for positive axillary lymph nodes. 2. Codes 25 and 60 may map to N1, N1a, N2a or N3a depending on the coding of SSF3. 3. Assign code 60 when there is not enough information to assign a code from 13 to 50. 4. CS instructions are the same for all users. There are no CS instructions specific to SEER registries. 5. Yes, assume lymph nodes are moveable (not matted, not fixed) when there is no information to the contrary. |
2006 |
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20061033 | Reportability--Brain and CNS: Is benign neural tissue compatible with a glioneuronal hamartoma of the cerebellopontine angle reportable? |
No. A glioneuronal hamartoma is not neoplastic and not reportable. See page 2 of the 2004 SEER Program Coding and Staging manual for the list of reportable brain/CNS tumors. There is no ICD-O-3 code for hamartoma. |
2006 | |
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20061023 | Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses? | No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3. | 2006 | |
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20061060 | CS Site Specific Factor--Prostate: How are SSF 5 (Gleasons Primary and Secondary Pattern Value) and SSF 6 (Gleasons Score) coded when there is a higher Gleason's pattern in less than 5% of the tumor? See Discussion. | Radical prostatectomy pathology states prostate adenocarcinoma "combined Gleasons score 3+3=6, with a small portion of Gleasons pattern 4 component comprising less than 5% of tumor volume." The WHO Classification of Tumors of the Urinary System and Male Genital Organs refers to "tertiary" Gleasons patterns in addition to the primary and secondary patterns. On prostatectomy, when this tertiary pattern is 4 or 5, WHO recommends that it should be reported in addition to the Gleasons score even when it is less than 5% of the tumor. |
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. Record Gleason's pattern and score from the largest specimen, even if this is a lower number. Ignore the tertiary pattern for now. This may change when the AJCC 7th Edition is published, as there is much discussion regarding the tertiary patterns and when they should be utilized. If there is a change in AJCC, at that time there will be a change to CS. |
2006 |
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20061041 | CS Site Specific Factor--Prostate: How is SSF 6 coded for this site when there is only one Gleason number documented and the number is less than 5 (e.g., Gleasons 3)? | 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 999 [unknown or no information]. Note 1 was revised in September 2006 to clarify this situation. Note 1 states "If only one number is given and it is less than or equal to 5, code the total score to 999, unknown or no information. |
2006 | |
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20061006 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Testis: If an orchiectomy specimen contains non-seminomatous mixed germ cell tumor and a separate satellite of seminoma, how many tumors should be abstracted and how should the histology field(s) be coded? | Pathology: R Orchiectomy: 2.1 cm non-seminomatous mixed germ cell tumor (50% teratoma primarily mature, 50% embryonal CA and yolk sac tumor). Located 3cm from the main tumor is a 2mm satellite pure seminoma. | For tumors diagnosed prior to 2007:
This is a single primary because the first three digits of the ICD-O-3 histology codes are the same, according to Rule 3a on page 11 of the 2004 SEER manual. Code the histology 9065 [Germ cell tumor, nonseminomatous]. Code 9065 is preferred over the less-specific code of 9061 [Seminoma, NOS].
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. |
2006 |
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20061039 | CS Tumor Size/CS Site Specific Factor--Breast: Should the tumor size be coded to 1.5 cm or 2.5 cm and SSF6 coded to 020 or 030 respectively for a tumor with invasive and in situ components described as being a 2.5 cm tumor with a "greater than" 1.5 cm invasive portion? See Discussion. | Should tumor size be coded to 1.5 cm and SSF6 coded to 020 [Invasive and in situ components present, size of invasive component stated and coded in CS Tumor Size] or should the tumor size be 2.5 cm with SSF6 coded to 030 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated and in situ described as minimal (less than 25%)]? | 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 CS tumor size 992 [stated as greater than 1 cm] and SSF6 code 020. The September 2006 revision to the CS Tumor Size table now lists the 992-995 range codes as "greater than ___ cm." It is better to code the invasive size than the entire size of the tumor. In the TNM mapping, this would more accurately portray the tumor as T1c rather than T2. |
2006 |