Report | Question ID | Question | Discussion | Answer | Year |
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20071006 | Primary Site: Is an "angiosarcoma" stated as arising in the skin of the breast and treated with a mastectomy, coded to the primary site of skin or breast? | Code the primary site as skin of breast when skin of breast is documented as the site of origin. According to the WHO classification of soft tissue tumors, the majority of angiosarcomas "develop as cutaneous tumors...less than one quarter present as a deep soft tissue mass." |
2007 | |
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20071117 | MP/H Rules/Histology--Brain: How many primaries are reported and what is the histology for a single brain tumor described as a low grade astrocytoma at the time of the initial partial resection and a low grade glioneuronal neoplasm at the time of the subsequent total resection? See Discussion. | On 4/20/07 a partial resection of a brain tumor is interpreted as low grade astrocytoma. Patient has a gross total resection on 8/13/07 with this diagnosis: low grade glioneuronal neoplasm (see comment). Comment: This case has been reviewed at ---. Dr. agrees with our interpretation (low grade glioneuronal neoplasm, possibly a dysembryoplastic neuroepithelial tumor). | For cases diagnosed 2007 or later, this is a single primary. A single tumor is always a single primary. Assign histology code 9400/3 [Astrocytoma, low grade]. This diagnosis was not revised or amended based on the later surgery. It is possible that the malignant component was entirely removed during the first surgery. |
2007 |
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20071025 | Radiation Therapy: How is radiation coded when it is "recommended" but the patient dies before radiation is started? See Discussion. | Code 0 seems appropriate but then we would lose the fact that it had been recommended. All of the other modalities give an option for 'recommended but patient died prior to treatment.' Is there a reason this option is not given for radiation? | Code Radiation (Rx Summ--Radiation) to 0 [None; diagnosed at autopsy].
SEER does not collect the Reason For No Radiation field. However, those who abstract using software that captures this data item can identify these cases. Code 5 [radiation not administered because patient died] reflects this situation.
Radiation (Rx Summ-Radiation) is a SEER field. This field is derived from the data collected in Rad-Boost Rx Modality and Rad-Regional TX Modality. These fields do not include a choice for "radiation not given because the patient died prior to treatment." Therefore, this information cannot be coded in the Radiation field. |
2007 |
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20071073 | MP/H Rules/Histology--Breast: How is histology coded for a single tumor with ductal and tubular features in only the invasive component and not in the in situ component? See Discussion. | A breast tumor diagnosed in Feb. 2007 is a single tumor with in situ and invasive components. The invasive component is diagnosed as ductal with tubular features. The only rule that applies is H9 which says 'code the invasive histology.' Is it ductal (8500) or tubular (8211)? If you continue through the H rules, then H12 does not apply, because tubular is not a type of ductal. So then you end up at H17, which would make this 8523. Which code is correct? |
For cases diagnosed 2007 or later, code the histology 8523 [duct mixed with other types of carcinoma]. After determining that the invasive histology is to be coded using rule H9, there is another decision to make in this case -- which invasive histology should be coded? Make a second pass through the histology rules, begining with rule H10. Stop at H17 and code 8523. This advanced concept of a "second pass" through the rules is discussed in an online web training session called "Beyond the basics." Go to the SEER website to view this session http://www.seer.cancer.gov/tools/mphrules/training_advanced.html |
2007 |
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20071080 | First Course Treatment--Liver: Given that agents can be used that are not chemotherapy drugs, how should treatment be coded for a procedure called a "chemoembolization" when the agent used is not documented? | This issue was discussed among the national standard setters and per the SEER website this issue has been resolved as follows: When "chemoembolization" is done but the agents used are not chemotherapy drugs, then treatment should be coded as "Other Therapy." See http://seer.cancer.gov/tools/codingmanuals/embolization.html | 2007 | |
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20071012 | Reportability--Melanoma: Is a skin excision final diagnosis of "melanocytic tumor with uncertain malignant potential" reportable if the path COMMENT states the initial shave biopsy diagnosis was "melanocytic tumor with uncertain malignant potential [minimal deviation melanoma]"? See Discussion. | SKIN, RIGHT FOOT, EXCISION: CHRONIC SCARIFICATION WITH RESIDUAL ATYPICAL MELANOCYTES IN THE DERMIS IDENTIFIED, BUT COMPLETELY EXCISED.
Comment: The prior outside biopsy report indicates that the lesion was a melanocytic tumor of uncertain malignant potential (minimal deviation melanoma) measuring at least 2.5 mm in depth. There was apparently no in situ component. Special stains performed here are similar, with positive reactivity for Melan A and S-100. The cells are atypical, but there are reactive changes, making it impossible to accurately assess the true nature of the lesion in this biopsy. If this is a minimal deviation melanoma, it would be classified as a T3 (T3a since there is no description in the outside report of ulceration) lesion. The atypical melanocytes extend to a depth of 1.1 mm in this 2 mm deep biopsy, but are completely excised, both at the deep margin and at all of the peripheral margins (closest margin is superior, with clearance of 7 mm).
PATH FROM INITIAL BIOPSY: Diagnosis: Rt dorsal foot, shave biopsy: Melanocytic tumor of uncertain malignant potential (see comment). Tumor depth at least 2.5mm Deep margin involved. Comment: As a primary lesion, I would favor that this represents a melanocytic tumor with indeterminate biologic potential also known as minimal deviation melanoma. The lesion does extend to the deep margin and wider excision is recommended. |
This case is not reportable. Based on the information provided, there is no definitive diagnosis of malignancy. | 2007 |
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20071065 | MP/H Rules/Multiplicity Counter--Lung: If metastatic tumors are not counted in this field, should the multiplicity counter be coded to 01 for a case with a primary left lower lobe of lung tumor with a satellite tumor in the left upper lobe? | For cases diagnosed 2007-2013: No, code multiplicity counter to 02 [two tumors present]. According to the multiple primary rules, these two lung tumors are reported as a single primary. Record the number of tumors reported as a single primary in Multiplicity Counter.
Multiplicity Counter no longer required by SEER as of 1/1/2013. |
2007 | |
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20071016 | MP/H Rules/Multiple Primaries--Bladder: The new multiple primary rule M7 states that tumors diagnosed more than three years apart are multiple primaries. Does this apply to in situ bladder tumors that occur more than three years apart and to an in situ tumor that occurs three years after an invasive tumor? | For cases diagnosed 2007 or later, use the MP/H rules in order. Rule M6 comes before rule M7.
M6 states that bladder tumors with certain histologies are a single primary. It is a single primary regardless of timing if there is any combination of:
Rule M7 applies to bladder tumors with histologies other than those listed above. If you have such a case, rule M7 applies to in-situ tumors and to an in situ three years after an invasive. |
2007 | |
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20071037 | CS Extension--Breast: Is the term "erosion" the same as "ulceration"? | 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. "Erosion" is not synonymous with "ulceration" when coding CS extension for breast. |
2007 | |
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20071057 | Primary Site/CS Extension--Lymphoma: How are these fields coded for a lymphoma found in the spleen and retroperitoneal lymph nodes? See Discussion. | A patient presents with a 6-month history of night sweats, low grade fever and significant weight loss. Physical exam reveals no palpable lymph nodes, tender abdomen and splenomegaly. Patient undergoes an exploratory laparotomy with splenectomy and dissection of two retroperitoneal lymph nodes. Spleen and both lymph nodes were positive for small cleaved-cell lymphoma, high grade. | Code the primary site to spleen. Code CS extension as 22 [involvement of spleen plus lymph nodes below the diaphragm]. This gives it a stage IIS. Spleen is an extranodal (not extralymphatic) site. The retroperitoneal lymph nodes are located below the diaphragm. |
2007 |