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Report Produced: 11/06/2024 20:21 PM

Report Question ID Question Discussion Answer Year
20071083 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.

 2007
20071114 Ambiguous Terminology/Date of Diagnosis: How would you code the diagnosis date when the body of an imaging report uses reportable ambiguous terminology while the final impression in that same report uses non-reportable ambiguous terminology? Would you code the diagnosis date to the date of the scan or to the subsequent biopsy date that confirmed a malignancy? See Discussion. Within the body of a mammogram report, the radiologist stated, "diffuse inflammatory tissue throughout the rt breast w/ large rt axillary lymph nodes, consistent with an inflammatory carcinoma of rt breast." His final impression, however, said "extremely suspicious rt breast w/ extremely dense breast parenchyma and adenopathy in axilla, suggesting an inflammatory carcinoma." The patient then went on to have a biopsy, which was indeed positive for cancer.

Accept the reportable ambiguous terminology from the body of the mammogram. Record the date of the mammogram as the date of diagnosis.

The guidelines on page 4 of the 2007 SEER manual addressing discrepancies within the medical record can be applied to discrepancies within one report.

The instructions are:

If one section of the medical record(s) uses a reportable term such as

apparently and another section of the medical record(s) uses a term that is not on the reportable list, accept the reportable term and accession the case.

 2007
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
20071130 Reportability--Brain and CNS: Are schwannomas of the spinal cord reportable when they are intradural? See Discussion. The CNS guidelines basically indicate that schwannomas must all come from peripheral nerves and thus are not reportable when they are on the spinal cord. However, the COC Inquiry 18174 & 18068 states that schwannomas occasionally will develop inside the dura (intradural) on the spinal cord and would be reportable.

According to an expert consultant, schwannomas must be derived from Schwann cells which are not a part of the CNS. All schwannomas come from peripheral nerves. Benign and borderline tumors of the peripheral nerves (C47_), including peripheral nerves along the spinal cord, are not reportable.

Please see http://www.cdc.gov/cancer/npcr/training/index.htm for more information.

 2007
20071027 MP/H Rules/Histology--Breast: Which report and diagnosis should be used to code the histology if an excisional biopsy that removes the majority of the tumor has a diagnosis of "carcinoma," and the subsequent lumpectomy diagnosis is "microscopic residual disease consistent with infiltrating duct carcinoma"? For cases diagnosed 2007 or later, code histology for this case to 8010 [carcinoma]. The histology is coded from the pathology report with the most representative specimen (the most tumor tissue) even when the most representative specimen has a less specific histology. 2007
20071124 Multiplicity Counter-Breast: The general instructions say to ignore separate microscopic foci when determining when to use the single tumor or multiple tumor modules. Do these instructions apply if sizes are given for the foci? See Discussion. For instance, would a 1.2 cm breast tumor with 3 scattered microscopic foci ranging from 2-4 mm be treated as multiple tumors (4), or as a single tumor? If the microscopic foci are measured and listed as part of the diagnosis, they should be counted as multiple tumors. 2007
20071082

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.

 2007
20071098 Multiplicity Counter/Date of Multiple Tumors/CS Tumor Size--Lung: How are these fields to be coded when work-up of a malignancy spans a couple of months and reveals developing nodules? See Discussion. Example: Chest CT on 4-26-07 reveals 2.2 cm mass in lingula, left lung, consistent with lung malignancy. Biopsy on 5-18-07 shows non-small cell carcinoma. PET scan on 6-6-07 shows left upper lobe mass consistent with known non-small cell lung carcinoma. Second developing mass increasing in prominence since 4-07 in periphery of left upper lobe, approximately 3.6 cm which may represent intrapulmonary mets or second primary neoplasm. At least 3 additional intrapulmonary nodules have developed since 4-07, two in the left upper lobe and one in the right upper lobe, suspicious for mets.

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.Multiplicity Counter/Date of Multiple Tumors

Apply the multiple primary rules first and record the number of tumors determined to be a single primary in Multiplicity Counter. Record the corresponding date in Date of Multiple Tumors. These data items may be updated once if future tumors are determined to be the same primary as the initial diagnosis.

CS Tumor Size

Include information gathered through

  • completion of surgery(ies) in first course of treatment OR

  • all information available within four months of the date of diagnosis in the absence of disease progression

    • WHICHEVER IS LONGER.

    Metastasis known to have developed after the diagnosis was established should be excluded.

    		 2007
    		20071103 MP/H rules/Histology--Breast: How many primaries and what histologies are coded for a left breast when a bi-lumpectomy path reveals one tumor with a microscopic focus of mucinous adenocarcinoma and extensive DCIS and a second .9 cm mucinous adenocarcinoma with extensive DCIS, and the subsequent mastectomy reveals foci of residual DCIS and Paget's disease of the nipple?

    For cases diagnosed 2007 or later:

    There are two primaries. Primary 1: The two tumors described on the pathology report from the lumpectomy are a single primary using rule M13. Primary 2: Disregard the foci of residual DCIS. Paget disease of the nipple is a separate primary using rule M12.

    Primary 1: invasive mucinous adenocarcinoma and extensive ductal carcinoma in situ: Code the histology as 8480/3 [mucinous adenocarcinoma] using rule H27.

    Primary 2: Paget disease of nipple: Code the histology as 8540/3 [Paget disease] using rule H14.

    		 2007
    		20071092 Reportability/Primary Site--Brain and CNS: Is a chondroma, NOS or a chondroblastoma, NOS that occurs in an intracranial site or along the spinal cord reportable? See Discussion.

    In ICD-O-3, chondroma and chondroblastoma are site-associated morphologies for bone. If a chondroma or a chondroblastoma occurs along the spinal cord, is this one of those situations where we can be quite comfortable with a default site to bone and not to spinal cord?

    Reference: ICD-O-3; Primary Central Nervous System Tumors, NPCR Training Materials 2004; SINQ 20021152

    Chondroma, NOS or chondroblastoma, NOS occuring in intracranial sites or along the spinal cord are not reportable.

    Chondroma, NOS and chonroblastoma, NOS are benign tumors of the bone itself, not the intracranial contents.

    		 2007