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Report Produced: 01/28/2023 02:52 AM

Report Question ID Question Discussion (Descending) Answer

Reportability/Brain and CNS:  Is a 2021 case of ecchordosis physaliphora (lesion within the prepontine cistern) on brain MRI reportable?

Ecchordosis physaliphora is not reportable.


Histology:  Is there any guidance on using STRATA Oncology testing (molecular tumor profiling tests), such as StrataNGS and StrataEXP, to code SSDIs, histology, etc? I do not see anything in STR, SEER Program Manual, SINQ, or CAnswerForum. We are seeing the testing with our 2021 paths.

We recommend that you do not use information from these molecular tumor profiling tests until they become a standard diagnostic tool. If/when that happens, we will add information to the various manuals.


Reportability/Histology--Soft Tissue:  Is atypical spindle cell neoplasm, primitive myxoid mesenchymal tumor of infancy (PMMTI) from the soft tissue of the leg in August of 2019, reportable? 

Primitive myxoid mesenchymal tumor of infancy (PMMTI) is reportable. PMMTI is listed in the new WHO 5th edition Classification of Soft Tissue and Bone Tumors under round cell sarcomas. This is a variant of BCOR sarcomas. There is a new ICD-O histology code assigned for cases diagnosed in 2022 or later (9368/3). Code this 2019 case to round cell sarcoma, undifferentiated 8803/3. Use text fields to explain the details.


Tumor Size--Pathologic--Anus: In 2019, the pathology report of an anal canal squamous cell carcinoma stated the tumor size is 2.5 cm from proximal to distal (3.5 cm in circumference).  Is the pathologic tumor size tumor size 025 or 035? 

Based on the information provided, code the tumor size as 035.  We asked an expert pathologist to review this question and she said to use the larger measurement.  She also said "the pathologist usually cuts the anus and rectum open like a tube; the “circumference” would be measured flat."


Reportability/Histology--Anal Canal:  For cases diagnosed in 2021, is anal intraepithelial neoplasia (AIN) II reportable?   There is conflicting information regarding the reportability for AIN II.  SINQ 20210048 says to report AIN II but the 2021 SEER Manual Appendix E states intraepithelial neoplasia (8077/2 and 8148/2) must be unequivocally stated as grade III to be reportable.

AIN II is reportable for 2021. Squamous intraepithelial neoplasia, grade II is listed in ICD-O-3.2 as 8077/2 making it reportable for cases diagnosed in 2021. AIN is a type of squamous intraepithelial neoplasia.

The wording in Appendix E of the 2021 SEER manual (must be unequivocally stated as grade III to be reportable) was left over from earlier versions and is not correct for 2021 diagnoses. Follow the guidance in SINQ 20210048.


Reportability/EOD--Ovary:  Bilateral ovary shows gonadoblastoma with germ cell neoplasia in situ (9064/2). Pathology report clearly states in situ. Is this case reportable?

If this case is reportable, how would you code Extent of Disease (EOD) Primary Tumor and SEER Summary Stage (SS)? In situ code 000 for primary tumor and code 0 for SS 2018 is not given as an option. 

Report germ cell neoplasia in situ (9064/2). Assign 999 for EOD Primary Tumor and assign 9 for SS2018.

This particular histology is in the Soft Tissue Abdomen and Thoracic schema where EOD PT 000 and SS2018 0 are not available. This histology will be moved to the Ovary schema after redefining certain schemas and thus making the more accurate choices for EOD and SS2018 available. The schema redefine is planned for 2024 implementation.


Tumor Size/Neoadjuvant Treatment:  If a patient discontinues neoadjuvant therapy and then has surgery, how is the pathologic tumor size coded with the pathologic tumor size greater than the clinical tumor size? Currently, we are instructed to code 999 for the pathologic tumor size when neoadjuvant therapy is given; what happens when neoadjuvant chemotherapy is discontinued after 3 cycles (plan for 4 cycles)? 

Assign 999 for pathologic tumor size when patient has received neoadjuvant therapy, even when neo-adjuvant therapy is not completed. Describe the details in text fields.


Reportability/Histology--Testis: Is micropapillary serous borderline tumor reportable? Pathology states Testis (C621) radical orchiectomy: Micropapillary serous borderline tumor. 

We consulted an expert genitourinary pathologist who advises that micropapillary serous borderline tumor of the testis is reportable. He states "it is the same neoplasm as in the ovary. It arises from tissue (tunica vaginalis) surrounding the testis so is a paratesticular neoplasm." 

 Please note: not all borderline tumors are reportable and this diagnosis is an exception because it is assigned /2 in ICD-O-3.2. It is reportable for cases diagnosed Jan 1, 2021 and later.


When coding the Covid testing results, does SEER have any guidance on whether or not at home tests fall within reportability? For instance, if a medical provider says pt tested positive on an at home test, do we record that?

When you have information about home COVID tests, record this information. For example, if the home test was positive record as follows: COVID-19 rapid viral antigen test POS 08/09/2022


First Course Treatment/Neoadjuvant Therapy--Melanoma:  How are the three Neoadjuvant Therapy data items (Neoadjuvant Therapy, Neoadjuvant Therapy--Clinical Response, Neoadjuvant Therapy--Treatment  Effect) coded when a patient is diagnosed with melanoma in the lymph nodes with no primary skin site identified? The physician gives immunotherapy as neoadjuvant therapy with planned and carried out surgical resection of involved lymph nodes following completion of immunotherapy. There is no "planned definitive surgical resection of the primary site" as no primary site was found,

Assign code 0 to each of the three Neoadjuvant Therapy data items in this situation.

We will add an example to the coding instructions for these data items in the next release of the manual.