Report | Question ID | Question | Discussion | Answer | Year |
---|---|---|---|---|---|
|
20000465 | Grade, Differentiation--Lymphoma: What code is used to represent this field when the only grade/differentiation given is "low grade", "intermediate grade" or "high grade"? | Code the Grade, Differentiation field to 9 [cell type not determined, not stated or not applicable]. For lymphomas, do not code the descriptions "high grade," "low grade," and "intermediate grade" in the Grade, Differentiation field. These terms refer to categories in the Working Formulation and not to histologic grade for lymphoma histologies.
Generally, for histologies other than Non-Hodgkin lymphoma, the Grade, Differentiation field is coded to 2 [low grade], 3 [intermediate grade] and 4 [high grade] for most cancers. |
2000 | |
|
20000247 | EOD-Pathologic Extension--Prostate: If there is residual tumor in the distal urethra on prostatectomy, does that mean there is distal urethral margin involvement? See discussion. | 2/98 Prostate bx: Right apex, right mid and right base positive for adenocarcinoma. 6/1/98 Radical retropubic prostatectomy w/ bilateral pelvic lymph node dissection. Pathology: Residual adenocarcinoma in distal urethra, right lateral sections and posterior lobe. Right apical margin, other margins, seminal vesicles, and 7 pelvic LN negative for malignancy. |
For cases diagnosed 1998-2003: For the example above, code the EOD-Pathologic Extension field to 34 [extending to apex] because most of the right side is involved. The pathology report says all margins are free. The comment on residual tumor in the urethra, meant the first surgery did not completely remove tumor tissue from the urethra, it does not mean that tissue is at the margin. |
2000 |
|
20000258 | EOD-Extension--Lung: If a CT scan indicates that a patient has evidence of "long-standing pneumonia," is that synonymous with "pneumonitis" for the purposes of coding extension for lung primaries? |
No. These terms are not synonymous. For cases diagnosed 1998-2003, disregard the pneumonia and use the other available information to code extension. |
2000 | |
|
20000438 | EOD-Extension/SEER Summary Stage 2000--Kidney/Eye: What codes are used to represent these fields for simultaneous bilateral Wilms tumor or simultaneous bilateral retinoblastoma? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 85 [Metastasis] and the SEER Summary Stage 2000 field to 7 [Distant] for both types of tumor. Each kidney and each eye are staged separately in the AJCC, 6th ed., but for SEER we would abstract these diagnoses as one case and code the EOD and stage fields to distant to reflect the involvement of both eyes or both kidneys. |
2000 | |
|
20000452 | Other Therapy: What code is used to represent "gene" therapy? See discussion. | The following form of gene therapy has been described as treatment for malignant brain tumors.
Patients undergo surgery to remove as much of the tumor as possible. After surgery, the patients are infused with a virus that has been genetically altered so that it is not infectious and so that it contains a gene from the herpes simplex virus. The herpes gene is sensitive to a drug called ganciclovir. Once inside the brain, the genetically altered virus infects any remaining tumor cells. When this occurs, the herpes gene is established inside the cancer cells. After the virus infects the cancer cells, the patients are given ganciclovir. This drug would kill both the virus and the brain tumor cells. |
Code the Other Cancer-Directed Therapy field to 2 [Other experimental cancer-directed therapy (not included elsewhere)]. | 2000 |
|
20000515 | Multiple Primaries (Pre-2007)--Ovary/Endometrium: Is endometrioid adenocarcinoma occuring simultaneously in the left ovary and the endometrium one primary or two? See discussion. |
Pathology Final Diagnosis: Left Ovary: Moderately differentiated endometrioid adenocarcinoma squamous differentiation grade 2 (scale of 3) Uterus: Moderately differentiated endometrioid adenocarcinoma with squamous differentiation, grade II (scale of III). Focal, very superficial invasion to inner third myometrium with extension to lower uterine segment. Endocervix, cervix, right ovary and fallopian tubes negative for tumor. |
For tumors diagnosed prior to 2007: Code the case you describe as two primaries. The endometrioid adenocarcinoma can arise in the endometrium without a concomitant ovarian carcinoma. 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. |
2000 |
|
20000843 | Place of Birth: When there is conflicting information, which record takes precedence in coding this field, the medical record or the death certificate? | If there is a discrepancy, use the information from the medical record to code the Place of Birth field. The information from the medical record is provided by the patient, the information on the death certificate is provided by others. If the medical record does not contain birth information, use the information from the death certificate. | 2000 | |
|
20000418 | Measured Thickness/EOD-Extension--Melanoma: If the Clark's level is not provided, can it be estimated using the depth of invasion provided in the pathology report and associating that number with the Clark's levels identified in the SEER Summary Staging Guide? | For cases diagnosed 1998-2003:
No. Do not use the SEER Summary Stage Guide or any other guide to derive an estimated Clark's level from the thickness identified in the pathology report. The two measurements need to come directly from the pathology report. Each is coded separately in EOD. Thickness is collected in a separate field so we can capture the actual measurement stated in the pathology report. This has made it possible for us to group depth of invasion for analysis purposes in any manner we might wish. In addition, we can always collapse this information to the Summary Stage or TNM using the AJCC rules. AJCC rules use both depth of invasion and thickness in determining pathologic staging, and, if there is an inconsistency between them, the rules say code to the higher T classification, that is, the least favorable finding. |
2000 | |
|
20000842 | Surgery of Primary Site--Skin: Explain the difference between code 30 and code 45.
Code 30 [Biopsy of primary tumor followed by a gross excision of the lesion]
Code 45 [Wide excision or re-excision of lesion or minor (local) amputation with margins more than 1 cm, NOS. Margins MUST be microscopically negative.] |
For cases diagnosed 1/1/2003 and after: Code 30 represents a biopsy or excision in which the margins of excision are less than 1 cm or the margins are unknown. Code 45 represents a wide excision in which it is known that the margins of excision are greater than 1 cm. | 2000 | |
|
20000514 | Histology (Pre-2007)--Skin: Are "atypical melanocytic hyperplasia" and "severe melanotic dysplasia" synonyms for melanoma in situ? |
For tumors diagnosed prior to 2007: No. SEER determines its reportable list from the ICD-O-3. The above terms are listed as tumor-like lesions and conditions, but are not in situ or malignant. 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. |
2000 |