Type of Multiple Tumors--Colon: How is this field coded for a case in which the patient is found to have two in situ polyps and an adenocarcinoma arising in a polyp all in the same segment of the colon? See Discussion.
Code 30 would not count the fact that these are polyps. Code 31 states "AND a frank adenocarcinoma." What would be the correct code?
Assign code 30 [In situ and invasive] in this case. Code 31 does not apply here because frank adenocarcinoma is not present.
Reportability--Brain and CNS: In addition to Schwannoma, are there additional types of benign tumors that arise in peripheral nerves along the spinal cord that are not reportable? See Discussion.
Are neuroepitheliomatous neoplasms such as ganglioneuroma, gangliocytoma, ganglioglioma occurring along the spinal cord reportable? Are nerve sheath tumors such as neuroma occurring along the spinal cord reportable? Angioma?
Reference: SINQ 20051071; Primary Central Nervous System Tumors, NPCR Training Materials 2004
Reportability depends on the location of the tumor. Tumors in the following sites are reportable:
C700 - C709
C710 - C719
C720 - C729
C751 - C753
Benign and borderline tumors of the peripheral nerves (C47_), including peripheral nerves along the spinal cord, are not reportable.
Please note: spinal schwannomas arising in the nerve root or spinal dura are reportable.
MP/H Rules/Multiple Primaries--Bladder/Renal Pelvis: Is a non-invasive papillary transitional cell carcinoma of the bladder diagnosed one year after the occurrence of an invasive papillary transitional cell carcinoma of the renal pelvis reported as one or two primaries?
For cases diagnosed 2007 or later:
This is a single primary with renal pelvis as primary site.
Use the 2007 MP/H rules to determine if the 2007 diagnosis is a new primary. Use the Urinary rules, multiple tumors module. Start with rule M3. Follow the rules down to Rule M8 and stop. This is an example of implantation effect.
MP/H Rules/Recurrence: Is a subsequent diagnosis of an in situ tumor (bladder cancers excluded) a "recurrence" if it follows a prior invasive diagnosis of the original primary cancer made 5 years before?
For cases diagnosed 2007 or later, use the 2007 MP/H rules to determine whether or not a subsequent diagnosis (either invasive or in situ) is a new primary or a recurrence. Do not use the statement "recurrence" from the medical record to make this decision.
When evaluating a subsequent diagnosis and the MP/H rules indicate "single primary," the tumor being evaluated is a "recurrence" of the original primary cancer.
CS Extension/Histology (Pre-2007)--Bladder: Is the histology coded to 8010/2 [carcinoma in situ] or to 8130/2 [papillary transitional cell carcinoma, non-invasive] for a 2006 bladder tumor with a final path diagnosis of "mixed non-invasive papillary TCC and flat carcinoma in-situ" and is CS Extension coded to 01 [Papillary transitional cell carcinoma state to be noninvasive]or to 06 [Carcinoma in situ]? See Discussion.
If the correct code for histology is 8130/2 and CS Extension is 06, this combination does not pass NAACCR edits.
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, code CS Extension to 06 and histology to 8130/2. Override the NAACCR edit.
For cases diagnosed 2007-2014, 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.
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.
Reportability/Diagnostic Confirmation: If a diagnosis based solely on positive flow cytometry is reportable even if a bone marrow biopsy is negative, how is diagnostic confirmation coded?
For cases diagnosed prior to 2010
The case is reportable if a recognized medical practitioner says the patient has cancer.
A flow cytometry alone is not diagnostic but it may be supported by either a positive bone marrow or a clinician's statement. If the clinicians statement is based only on flow cytometry, code diagnostic confirmation to 8 [Clinical diagnosis only].
CS Site Specific Factor--Prostate: Given that the CS Manual instruction is to code the highest PSA value recorded in the medical record, can a PSA value obtained a year prior to admission be used to code the SSF 1 and SSF2 fields?
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.
The PSA recorded in CS SSF 1 and 2 must be documented in the medical record. Record the highest PSA value prior to diagnostic biopsy or treatment. If the highest PSA value documented in the medical record is from the previous year, record it.
Date of Diagnosis: Can the phrase "suspicious for a primary lung tumor" from a CT be used to code date of diagnosis? See Discussion.
Thorax CT on 4/18/05 states 'enlarged RUL nodular opacity suspicious for a primary lung tumor.' Biopsy confirmation was not done until 8/4/05 because patient declined further work-up until then. Would date of diagnoses be 4/18/05 or 8/4/05?
Code the diagnosis date 08/04/2005 based on the biopsy.
The statement "suspicious for a primary tumor" is not a clinical diagnosis of cancer or malignancy.
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