CS Site Specific Factor 6--Breast: Can we interpret the in situ component as "minimal" when the pathology report states "1.1 cm infiltrating duct carcinoma and no extensive intraductal component"?
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.
Yes. Based on the information provided above, the in situ component is "mininmal" for the purpose of coding Breast CS Site Specific Factor 6. The phrase "no extensive intraductal component" suggests that there is some intraductal carcinoma present.
Multiple Primaries (Pre-2007)--Soft Tissue: Does SEER agree that one primary of the soft tissues of pelvis [C49.5] should be reported when a pathologic diagnosis for bilateral herniorrhaphies is "right and left inguinal hernias with low grade spindle cell sarcoma"?
For tumors diagnosed prior to 2007:
Yes. This is one primary and should be coded to C49.5 [Connective, subcutaneous and other soft tissue of pelvis]. According to Rule A in ICD-O-3, the type of tumor ("sarcoma") indicates origin from a particular tissue, resulting in the primary site code of C49.5 [Inguinal region, NOS] for this sarcoma.
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.
Surgery of Primary Site--Ovary: What code is used to represent this field when a patient has a history of a previous organ removal and has additional surgery/organ removal for a present cancer (e.g., History of a 1984 hysterectomy and in 2003 has ovarian primary treated with BSO)?
For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 52 [Bilateral salpingo-oophorectomy WITH hysterectomy].
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.
The primary site is unclear. The lesion is intracranial, but this may not be the primary site. In the absence of any additional information, assign C390, 8020/3. According to WHO, sinonasal undifferentiated carcinoma can involve the nasal cavity, maxillary antrum, and/or ethmoid sinus.
SMARCB1 (INI-1) is a tumor-suppressor gene located on chromosome 22q11.2. Tumors that showed loss of expression were SMARCB1-deficient tumors which are characterized by nests, sheets, and cords of cells without any histologic evidence of specific (eg, squamous or glandular) differentiation.
Common variable immunodeficiency (acquired hypogammaglobulinemia) is not a reportable condition.
Common variable immunodeficiency represents a group of approximately 150 primary immunodeficiencies that have a common set of symptoms but different underlying causes, both benign and malignant.
The case is not reportable unless this immunodeficiency diagnosis is accompanied by a diagnosis of a cancer or a reportable hematopoietic or lymphoid neoplasm.
See Appendix F: Non-Reportable List for Hematopoietic Diseases.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.
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.
Surgery of Primary Site--Breast: How is this field coded when a patient has a reduction mammoplasty (for macromastia) and within the pathology specimen there is an incidental finding of carcinoma?
Code this reduction mammoplasty to the code which best fits the amount of tissue removed. Read the operative report carefully. Code as a partial mastectomy, skin- nipple- areola-sparing mastectomy, or total (simple) mastectomy. Use text fields to record the details.
Histology (Pre-2007)--Kidney: Is 8316/3 [Cyst associated renal cell carcinoma] the appropriate code for 1) Cystic renal cell carcinoma, 2) Renal cell carcinoma mass with cystic areas and 3) Cystic renal cell carcinoma, clear cell type?
For tumors diagnosed prior to 2007:
Yes, ICD-O-3 histology code 8316 is the correct code for the three examples above.
There are two categories of cyst-associated renal cell carcinomas: Renal cell carcinoma originating in a cyst, and Cystic renal cell 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.
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