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Welcome to the SEER Inquiry System (SINQ). SINQ is a collection of questions that cancer registrars have had while coding cancer cases. Click Search to look for specific questions or to select questions for a Report.

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Heme & Lymphoid Neoplasms/Diagnostic confirmation--Lymphoma: To code "3" in Diagnostic Confirmation, does the genetic testing need to confirm a specific histology or is it enough that is simply rules out others?  See Discussion.

Final Feb 02 2017

Reportability/Histology--Testis: Is neoplasm consistent with carcinoid type of monodermal teratoma reportable as a teratoma, NOS, and if yes, what is the histology code?

Final Jan 31 2017

MP/H Ruels/Histology--Kidney/renal pelvis: How is MiT family translocation renal cell carcinoma (RCC) with Xp11 translocation coded? See Discussion.

Final Jan 31 2017

Reportability/Histology--Brain and CNS: Is epidermoid tumor of the cerebellopontine angle (CPA) and trigeminal vesicle nerve reportable, and if so, what is the correct histology code? See discussion.

Final Jan 31 2017

Reportability--Brain and CNS: Are cavernous sinus meningiomas reportable? See Discussion.


Final Jan 18 2017

MP/H Rules/Histology--Kidney: How is the histology coded and what rule(s) apply to the classification of succinate dehydrogenase-deficient renal cell carcinoma? See Discussion.

Final Jan 17 2017

First course treatment/Chemotherapy: Is metronomic chemotherapy coded as chemotherapy?

Final Dec 20 2016

First course treatment/Radiation Therapy--Prostate: How do you code fiducial markers for prostate cases?

Final Dec 20 2016

First course treatment/Immunotherapy--Prostate:  Is XGEVA, given for bone mets from prostate cancer, abstracted as immunotherapy, or is it an ancillary drug and not recorded?

Final Dec 20 2016

MP/H Rules/Histology--Brain and CNS: What is the histology code for a tumor originating in the cerebellum and extending into the fourth venrticle described as a glioblastoma with primitive neuroectodermal tumor component (WHO Grade IV)?

Final Nov 21 2016

MP/H Rules/Histology--Breast: How should histology be coded for a breast primary with resection final diagnosis of "Ductal carcinoma with neuroendocrine features?" See Discussion.

Final Nov 10 2016

SEER Summary Stage 2000--Melanoma: Can Clark's level classification still used to Summary Stage melanoma? It was previously used by AJCC TNM, but was not included in the 7th edition. I see it is still listed in the CAP protocols for melanoma.

Final Nov 01 2016

Primary site/MP/H Rules/Histology: What is the appropriate site and histology code for a tumor described as a "Large mass In suprasellar cistern encroaching into sphenoid & ethmoid sinuses", with the pathology described as "INI-1 deficient sinonasal undifferentiated carcinoma"? Of note, this patient has a history of a pituitary adenoma, resected overseas a few months prior to this diagnosis.

Final Oct 31 2016

Reportability/MP/H Rules/Histology: Do we interpret Endometrial stromal sarcoma / Undifferentiated stromal sarcoma as low grade / high grade still in order to code the correct histology?

And for VIN, if a pathology report comes across as undifferentiated VIN, do we report it as VIN 3, even if that terminology isn't there?

Final Oct 24 2016

Reportability--Brain and CNS: Are sphenoid wing meningiomas reportable? See discussion.

Final Oct 18 2016

MP/H Rules/Histology--Skin: What histology code and MP/H Rule apply to a skin primary with the final diagnosis, Basaloid carcinoma with squamous and neuroendocrine differentiation? See Discussion.

Final Oct 18 2016

MP/H Rules/Histology--Breast: What histology code and MP/H Rule applies to the Histologic Type of "invasive ductal carcinoma with metaplastic stroma" for a single breast tumor? See Discussion.

Final Oct 11 2016

MP/H Rules/Histology--Lung: What histology code and MP/H Rule applies to the Histologic Type described as adenocarcinoma, mixed invasive mucinous and non-mucinous which involves multiple lung tumors present in a single lobe? See Discussion.

Final Oct 07 2016

Behavior--Prostate: What is the correct behavior of intraductal carcinoma from a prostate biopsy with a Gleason score 4+4=8. While highly aggressive, but not suggestive of invasion, coding behavior as /2 seems inappropriate.

Final Sep 28 2016

Grade--Kidney: Should WHO/ISUP grade for renal cell carcinoma be coded for cases diagnosed 2016 and later? See discussion.


Final Sep 14 2016

Reportability/Behavior--Small intestine: Is a carcinoid tumor, described as benign, reportable? See Discussion.

Final Sep 12 2016

Mets at diagnosis fields--Heme & Lymphoid Neoplasms (Lymphoma): How are Mets at Diagnosis -- Bone, Brain, Liver, Lung, Lymph Node, and Other -- to be coded for lymphomas in 2016? Are they always 0 if the TNM Stage is I, II, or III? How is bone marrow involvement coded -- in which Mets at Diagnosis field?

Final Aug 19 2016

First course treatment--Heme & Lymphoid Neoplasms: Are blood thinners, e.g., warfarin, coded as treatment in the Other Therapy data item for polycythemia vera and myelodysplastic syndrome? See Discussion.

Final Jul 05 2016

MP/H Rules/Histology--Prostate: What is the histology code for a prostate case whose histology reads “adenoca with mixed ductal and acinar variants?

Final Jun 23 2016

MP/H Rules/Histology--Testis: How should histology be coded for a testicular primary with a combination of teratoma, yolk sac tumor and embryonal carcinoma? See discussion.


Final Jun 14 2016

Reportability--Bone: Is an "atypical cartilaginous tumor" reportable? See Discussion.

Final Jun 13 2016

MP/H Rules/Multiple primaries--Melanoma: How many melanoma primaries should be abstracted if, during the workup for a metastatic melanoma of an unknown cutaneous site, an in situ melanoma is also discovered? See Discussion.

Final Jun 10 2016

MP/H Rules/Histology: How is the histology coded for an invasive adenocarcinoma arising in a papilloma with high-grade dysplasia? See Discussion.

Final Jun 08 2016

Summary Stage 2000--Lymphoma: How is SEER SS2000 coded for an ocular adnexal lymphoma when it extends from the primary site to adjacent sites that are still orbital structures? See Discussion.

Final Jun 03 2016

Diagnostic confirmation: When a CT guided Fine Needle Aspiration is performed and the pathology report indicates smears and cell block were prepared, if the diagnosis is positive for cancer, can you code diagnostic confirmation as 2 (positive cytology) because of the cell block?

Final Jun 02 2016

Reportability--Appendix: Is a mucinous cystic neoplasm with high grade dysplasia of the appendix reportable? See discussion.

Final Jun 01 2016

Grade/Sarcoma--Breast: Is the correct grade for high grade angiosarcoma of the breast a code 3 or 4? The breast usually uses a three grade system but sarcoma is not a typical histologic type of the breast.

Final May 31 2016

Reportability--Kidney: Is renal cell neoplasm of oncocytosis reportable based on the pathology from a nephrectomy? See Discussion.

Final May 31 2016

Reportability--Eye: Is conjunctival intraepithelial neoplasia (CIN III) from an excision of the left eye conjunctiva reportable?

Final May 31 2016

MP/H Rules/Multiple primaries--Bladder: How many primaries should be reported for the case below? See discussion.

Final May 23 2016

MP/H Rules/Histology--Sarcoma: What is the appropriate histology code for a final diagnosis of undifferentiated pleomorphic sarcoma and/or pleomorphic sarcoma, undifferentiated? See Discussion.

Final May 18 2016

MP/H Rules/Histology--Bladder: Should the term "dedifferentiation" be used to code sarcomatoid transitional cell carcinoma (8122/3)? Or is this typically referring to the grade, and not the histologic subtype? See Discussion.

Final May 18 2016

First course treatment/Date 1st surgical procedure--Colon: Should the date of a polypectomy be recorded in the Date of First Surgical Procedure field when the entire tumor is not removed by polypectomy? See Discussion.

Final May 10 2016

First course treatment/Surgery of Primary Site--Skin: How are Surgery of Primary Site and Surgical Procedure of Other Site coded for an eyelid skin primary diagnosed by punch biopsy and treated with an orbital exenteration? See Discussion.

Final May 05 2016

Reportability--Thyroid: Is a final diagnosis of "non-invasive follicular thyroid neoplasm with papillary-like nuclear features" reportable when the diagnosis comment states this tumor was historically classified as encapsulated follicular variant of papillary thyroid carcinoma? See Discussion.

Final May 05 2016

First course treatment/Surgery of Primary Site: If a procedure stated to be an "excisional biopsy" doesn't grossly remove the tumor, should Surgery of Primary Site be coded as an excisional biopsy? See Discussion for example.

Final May 05 2016

Birthplace/Place of birth, country: For patients originally born in a country that is currently considered as "historic only", where the original birth country now has a one-to-many relationship with the current country, how should the reported original birthplace be coded? (Example: Yugoslavia)

Final May 04 2016

Reportability/MP/H Rules/Histology--Ovary: What is the histology code for an ovarian tumor described as a mucinous borderline tumor, intestinal type?

Final May 03 2016

Reportability/Histology--Head and Neck: Is mammary analogue secretory carcinoma (MASC) of the left submandibular gland reportable and how is it coded? See Discussion.

Final May 02 2016

Reportability/Histology--Pituitary Gland: How are Rathke cleft cyst and Rathke pouch tumor distinguished and are they both reportable?

Final Apr 29 2016

First course treatment/Immunotherapy--Heme & Lymphoid Neoplasms: Is donor leukocyte infusion for treatment of hematopoietic neoplasms coded as a bone marrow transplant per the Hematopoetic Manual or as immunotherapy per SEER Inquiry System (SINQ) 20110048?  See Discussion.

Final Apr 29 2016

First course teatment/Surgery of Primary Site: Is microwave ablation (using heat not alcohol) coded to a surgery code? See Discussion.

Final Apr 29 2016

Reportability--Brain: Is benign lymphangioma of the brain (9170/0) reportable? It is not on the list of non-malignant blood vessel tumors in the National Program of Cancer Registries Clarifications for Central Nervous System (CNS) tumors.

Final Apr 29 2016

MP/H Rules/Histology--Brain and CNS: What is the code for Rosette-forming glioneural tumor from a pathology report of a brain tumor biopsy for a date of diagnosis in 2015? See Discussion.

Final Apr 29 2016

Reportability--Carcinoid: Is a diagnosis of carcinoid heart disease, based solely on clinical information and no pathology, reportable?

Final Apr 29 2016

Radiation Therapy--Breast: Are iodine 125 (I-125) seed implants for breast cancer coded as brachytherapy or as a localization technique similar to wire localization? See Discussion.

Final Apr 29 2016

MP/H/Histology--Sarcoma:  How should Ewing Sarcoma/primitive neuroectodermal tumor (PNET) be coded for a 2012 case?  See Discussion.

Final Oct 31 2016

MP/H/Histology--Pituitary: Would you code Crooke cell adenoma as 8272/0 pituitary adenoma?

Final Apr 28 2016

MP/H Rules/Histology: What is the correct histology code for a NUT midline carcinoma?

Final Apr 26 2016

Reportability--Melanoma:  Please explain how a CTR is to interpret the guideline in the MP/H rules (Cutaneous Melanoma): Evolving melanoma (borderline evolving melanoma): Evolving melanoma are tumors of uncertain biologic behavior. Histological changes of borderline evolving melanoma are too subtle for a definitive diagnosis of melanoma in situ. Is this to mean that evolving melanoma in situ is not reportable? Or should we follow the guidelines in SEER Question 20130022 that states the reportability terms for melanoma and melanoma in situ.

Final Mar 30 2016

Grade/Histology--Digestive System: What is the grade for neuroendocrine tumor (NET) or neuroendocrine carcinoma (NEC) of gastrointestinal morphologies described as: 1) NET G1 (M8240/3) and NET G2 (M8249/3) or 2) neuroendocrine carcinoma, low grade (M8240/3) and neuroendocrine carcinoma, well differentiation (M8240/3) and neuroendocrine carcinoma, moderate differentiation (M8249/3)? The SEER Instructions for Coding Grade for 2014+, Coding for Solid Tumors section, #3 state: Code the grade shown below (6th digit) for specific histologic terms that imply a grade. NET and NEC are not included in the specific terms.

Final Mar 07 2016

MP/H/Histology--Breast: What MP/H Rule, histology, and behavior code for a breast primary apply to the following?

2 foci DCIS, solid, high grade (Grade 3) w/microca++

Final Mar 07 2016

Primary Site--Stomach: How do I code the primary site when the operative report and pathology report state that the tumor site is incisura of the stomach?

Final Mar 07 2016

Reportability--Gallbladder: Is high grade biliary intraepithelial neoplasia of the gallbladder reportable?

Final Mar 07 2016

Reportability--Lung: Is a case of pulmonary metastatic leiomyoma (favored) vs. low grade leiomyosarcoma reportable, and if so, what is the primary site and histology code?  See Discussion.

Final Mar 04 2016

Reportability--Brain and CNS: Is a colloid cyst at the foramen of Monro reportable?

Final Mar 04 2016

Surgery of Primary Site--Melanoma: Please further explain the SEER Note under Melanoma surgery codes 30-36 for these two examples. Are both examples coded 31?

1. Shave bx: +melanoma in situ, +microscopic margins  Wide excision: no residual melanoma in situ

2. Shave bx: melanoma, +microscopic margin   Wide excision: Melanoma, margins negative (margin status negative but distance not stated)

Final Mar 02 2016

MP/H Rules/Histology--Bladder: Can the histology for a high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" be coded to sarcomatoid transitional cell carcinoma (8122/3)?
Example; TURBT, Final Diagnosis - Urothelial carcinoma, high grade. Type/grade comment: Extensive sarcomatoid dedifferentiation is present (40-50% of tumor volume).

Final Feb 29 2016

Multiple primaries--Heme & Lymphoid Neoplasms: Could you please clarify Note 2 found in Rule M10, which is " 'Transformations to' (acute neoplasms) and 'Transformations from' (chronic neoplasms) are defined for each applicable histology in the database." Do the neoplasms being considered have to contain the words 'chronic' and/or 'acute'?

Final Feb 26 2016

Surgery of primary site--Lung: Should microwave ablation be coded as treatment for lung cancer, and if so, how should it be coded?

Final Feb 17 2016

Reportability--Breast: Is mammary fibromatosis reportable and if so, what histology code is assigned? See discussion.

Final Feb 17 2016

Reportability--Brain and CNS:  Is a thalamic amyloidoma reportable if so what histology code is used?

Final Feb 17 2016

Reportability--Stomach: Are microcarcinoid tumors reportable? See discussion.

Final Feb 16 2016

Grade--Head & Neck: How should grade be coded for a tonsillar primary (or other solid tumor) with resection pathology final diagnosis of poorly differentiated SCC with histologic grade: G2-3 of 3. See discussion.

Final Feb 16 2016

MP/H Rules/Histology--Appendix: What is the histology for an appendix resection diagnosis of "Malignant neoplasm of the appendix with the following features: Histologic type: Adenocarcinoma ex goblet cell carcinoid with mucin production (adenocarcinoma arising from goblet cell carcinoid)"? Is this histology best coded to a mixed adenocarcinoma/carcinoid tumor (8244/3)?

Final Feb 16 2016

Reportability/Date of diagnosis--Liver: Is a statement of LI-RADS 5 or LI-RADS 4 diagnostic of HCC? See discussion.

Final Feb 16 2016

Surgery of Primary Site--Breast: If the diagnosis is a single primary involving both breasts, do we code 41 Surgery Primary site with 1 in Surgery Other site, or code 76 Surgery Primary site with 0 in Surgery Other site? See discussion.

Final Feb 05 2016

Diagnostic confirmation--Hem & Lymphoid Neoplasms: Can you please comment on the pathology profile of CALR? Can a + CALR profile be considered + immunophenotyping or genetic testing (similar to the JAK2 confirmation) and be used to code the diagnostic confirmation of Heme diseases?

Final Feb 01 2016

Reportability--Skin: Is this a reportable skin cancer? See discussion.

Final Jan 06 2016

First course treatment/Other therapy: How is Sirolimus (Rapamycin) to be coded when given with known chemotherapy agents in a clinical trial? See discussion.

Final Jan 05 2016

MP/H Rules/Multiple primaries--Thyroid: How many primaries should be reported for a diagnosis of Hurthle cell carcinoma (2.7 cm) and papillary carcinoma (0.3 cm) in the thyroid? See discussion.

Final Jan 05 2016

MP/H Rules/Histology--Breast: Which is the correct histology code to use and which MP/H rule applies in the case of a single lumpectomy specimen that demonstrates two separate tumors with the following histologies.
1) Invasive lobular carcinoma
2) Invasive ductal carcinoma with tubular features
See discussion.

Final Jun 23 2016

MP/H Rules/Multiple primaries/Histology--Rectum: How many primaries does this person have and what is the correct histology? See discussion.

Final Jan 04 2016

MP/H Rules/Histology--Kidney: What is the correct histology for this diagnosis? See discussion.

Final Dec 10 2015

Grade--Breast: Do you take grade from the most representative specimen along with the histology? What is the correct histology/grade combination? See discussion.


Final Dec 02 2015

First course treatment/Chemotherapy/Drug category: Instructions in SEER*Rx state that Ibrance should be coded as chemotherapy. They also state that it is an endocrine-based therapy. Local physicians refer to Ibrance as hormone therapy. Please clarify.

Final Nov 06 2015

Primary site--Head & Neck: When there is invasive in one subsite and in situ in another, do you code the subsite with the invasive only? Would the correct site be C320, C328, or C329? See discussion.

Final Nov 03 2015

Histology--Heme & Lymphoid Neoplasms: What is the correct histology for a case in which the pathology or clinician states only follicular lymphoma, low grade? See discussion.

Final Oct 30 2015

Grade--Bladder: How is Grade coded for the following cases diagnosed 1/1/2014 and later? See Discussion.

1) Low grade urothelial carcinoma, invasive carcinoma not identified (8120/2)

2) Papillary urothelial carcinoma, high grade, no evidence of invasion (8130/2)

Final Oct 30 2015

Reportability--Vulva: Is this reportable? We have begun to see the following diagnosis on biopsies of the vulva with the statement below. The diagnosis is being given as simply VULVAR INTRAEPITHELIAL NEOPLASIA, no grade is noted.  See discussion.

Final Oct 30 2015

Reportability/MP/H Rules: Where can I find documentation on how to accession malignant tumors in transplanted organs? See discussion.

Final Oct 29 2015

Primary Site--Liver: What is the topography code for combined hepatocellular carcinoma/cholangiocarcinoma (M-8180/3) especially when there is no documentation that intrahepatic bile duct is the tumor site? Reports usually just indicate a liver mass(es) but since the intrahepatic ducts are within the liver, is the code C221 due to the cholangiocarcinoma component, thus making the case stageable?

Final Oct 29 2015

MP/H Rules/Multiple Primaries: Is this counted as one or two primaries?

Patient is diagnosed with SCC esophageal cancer. Work-up reveals a lung nodule. Lung FNA (cytology) is read by the pathologist as SCC, favor metastatic esophageal SCC. However, the managing physicians are treating the patient as two separate primaries.

Final Oct 26 2015

Reportability--Brain and CNS: Is this diagnosis reportable? If this neoplasm originated in the spinal cord, it is reportable, correct?

Specimen is described as a 'spinal cord mass.' The final diagnosis is 'fragments of adipose tissue demonstrating vascular proliferations consistent with angiolipoma. No histologic evidence of malignancy.' The microscopic description says: Sections of the spinal mass reveal bone, cartilage, fibrous tissue and adipose tissue. The adipose tissue demonstrates increased vascularity with thin walled blood vessels seen with islands of delicate fibrous stroma. The histologic findings are compatible with fragments of angiolipoma.

Final Oct 21 2015

Multiple primaries--Heme & Lymphoid Neoplasms: Is this 2 primaries? In 2011, a patient had a spinal mass biopsied positive for DLBCL and follicular lymphoma. The heme rules make this one primary coded as DLBCL. Patient had 2 rounds of chemo, but in 2014, he had a recurrent tumor in the same location. The 2014 biopsy was follicular lymphoma. Is this a new primary -- conversion of acute to chronic after treatment? Or is it the same, since FL was diagnosed in the original specimen?

Final Oct 07 2015

Primary Site--Skin: Should cutaneous leiomyosarcoma be coded to primary skin of site (C44_) or soft tissue (C49_)?

Final Oct 02 2015

Primary Site--Sarcoma: What is the best primary site code for an undifferentiated sarcoma of the pulmonary artery? See discussion.

Final Sep 30 2015

Reportability--Brain and CNS: Is schwannoma of the extracranial part of a cranial nerve reportable? Some cranial nerves, like facial nerve, have intracranial and extracranial branches.

Final Sep 30 2015

Reportability: Is penile intraepithelial neoplasia, differentiated type, reportable? See discussion.

Final Feb 02 2016

Reportability--Brain and CNS: Is pseudotumor cerebri reportable?

Final Sep 29 2015

Reportability--Skin: Is low grade trichoblastic carcinoma, with a small focus of high grade carcinoma of the scalp reportable? See discussion.

Final Sep 29 2015

Reportability--Bladder: Is a positive UroVysion test alone diagnostic of bladder cancer? See discussion.

Final Sep 28 2015

Reportability--Appendix:  Is the appendix the primary site for a low grade mucinous appendiceal neoplasm (LAMN) with diffuse peritoneal dissemination?  See discussion.

Final Sep 28 2015

MP/H/Histology--Thyroid:  What is the histology code for primary site of thyroid cancer with the histology of papillary thyroid carcinoma, classical and oncocytic type?

Final Sep 28 2015

Reportability--Ovary: Is micropapillary serous carcinoma (MPSC) of the ovary reportable? What are the differences between “noninvasive" and “low malignant potential?"  See discussion.

Final Sep 28 2015
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