Report | Question ID | Question | Discussion | Answer | Year |
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20020062 | Histology (Pre-2007): Can the histology code 8582/3, "thymoma, mixed type, malignant" only be used when you have a thymoma with both type A and type B features? See discussion. | Can this same histology be used when you have two type B features in the thymoma specimen? What code is used to represent the histology?
Example 1: Thymoma, spindle cell and epithelial type Example 2: Thymoma, mixed lymphocytic and epithelioid type |
For tumors diagnosed prior to 2007:
For example 1, code histology to 8582 [Thymoma, type AB]. This code is only applicable to "Type AB thymoma [mixed]" in the WHO classification. Use 8582 only for thymomas with type A and type B features. Spindle cell is a type A feature and epithelial is a type B3 feature.
For example 2, code histology to 8585 [Thymoma, type B3]. Lymphocytic is a B1 feature (8583) and epithelial is a B3 feature (8585). There is no type A component. Code the histology based on ICD-O-3 rule K on page 34.
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. |
2002 |
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20021027 | EOD-Size of Primary Tumor: Should a 2.0 cm ulcerated mass be coded to 020 or 999 for tumor size? See discussion. |
With regard to tumor size, how would SEER interpret "2.0 cm ulcerated mass"? Should this be interpreted as an ulcer, or is it a gross description of the appearance of a mass and therefore acceptable to code tumor size to it? | For cases diagnosed 1998-2003:
If this ulcerated mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field to 020 [2.0 cm] based on the size of this mass in the absence of a more precise tumor size description. |
2002 |
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20021205 | EOD-Extension--Melanoma: Is "erosion" synonymous with "ulceration" for melanoma cases? | For cases diagnosed 1998-2003:
No, do not interpret the term "erosion" as a synonym for "ulceration" when coding the EOD-Extension field for melanoma. According to AJCC's melanoma curator, erosion is not necessarily the same as ulceration. |
2002 | |
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20021133 | First Course Treatment--All Sites: The patient has undergone part of the planned first course of treatment when a metastatic deposit is identified. If the patient continues with the planned first course of treatment, should the modalities of treatment given after the metastatic deposit is discovered be included in the coding of the first course of cancer-directed treatment fields? |
Yes, those modalities should be counted as part of first course of cancer-directed treatment if the patient continues with the planned first course. For example, if patient has the originally planned type of surgery, radiation, or drug protocol, then code the given treatment as first course. Caution: It is not a change in the treatment plan if the drugs are changed but the action of the drugs remains the same. This is still first course. However, if the treatment is changed from a chemotherapy drug to a hormonal drug following the discovery of the mets, do not code the hormonal therapy as first course. |
2002 | |
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20021180 | Surgery of Primary Site/Other Cancer-Directed Therapy--Head & Neck (Nasal cavity): Should a small fragment of bone removed during a maxillectomy following a turbinectomy for a nasal turbinate primary be "partial or total removal with other organ" for coding this field? See discussion. |
Excision of a turbinate mass and partial turbinectomy revealed melanoma of the rt nasal turbinate. A subsequent rt medial maxillectomy was performed and a small fragment of bone was included in the resection and identified in the pathology report. Would the removed bone be "connective or supportive tissue" only for a Surgery of Primary Site code of 40 or is it another organ for a code of 60? |
The piece of bone was likely removed to access the maxillary sinus and would not be a separate organ. Use the "All Other Sites" surgery coding schemes to code this primary. For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 40 [Total surgical removal of primary site]. Code the Surgical Procedure of Other Site field to 2 [Non-primary surgical procedure to other regional sites]. The maxillectomy was not performed in continuity to the turbinectomy and should be coded in this field rather than the Surgery of Primary Site field. |
2002 |
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20021126 | EOD-Extension--Head & Neck (Tonsil): How should the EOD-Extension field be coded for bilateral tonsil involvement? See discussion. | Tonsillectomy and bilateral radical neck dissections were done. The path diagnosis was left and right tonsils: squamous cell carcinoma, bilateral tonsils with negative inked surgical margins of resection. Physical exam and operative findings did not mention any extension beyond the tonsils. We originally coded the EOD-Extension field to 30 for a bilateral tonsil primary. The case failed the SEER Edit IF41 (Primary Site/Lat/EOD). According to that edit, if laterality is 4 then the EOD-Extension field must not be 00 through 30. We recoded the EOD-Extension field to 99 in order to comply with the SEER edit. |
For cases diagnosed 1998-2003:
Code EOD extension as 30 [Localized, NOS] and laterality as 4 [Bilateral involvement]. The next update to the SEER edits will allow this combination. |
2002 |
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20021125 | Histology (Pre-2007)--Testis: What code is used to represent the histology of "mixed germ cell tumor, embryonal carcinoma and mature teratoma" of the testis? See discussion. | Is the teratoma required to be described as "immature" or "malignant" in order to use the histology code of 9081/3 [mixed embryonal carcinoma and teratoma]? | For tumors diagnosed prior to 2007:
Code the Histology field to 9081/3 [Teratocarcinoma, mixed embryonal carcinoma and teratoma], in both ICD-O-2 and ICD-O-3.
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. |
2002 |
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20021111 | Histology/Grade, Differentiation--Lymphoma/Leukemia: Do you agree with coding a diagnosis of Nasal NK/T cell lymphoma to 9719/38? | For cases diagnosed prior to 1/1/2010:Yes. Code the Grade, Differentiation field to 8 [NK cell] rather than 5 [T-cell]. Code the Histologic Type to 9719/38 [NK/T-cell lymphoma, nasal and nasal-type with Cell indicator of NK (8)]. For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2002 | |
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20021094 | EOD-Extension/EOD-Lymph Nodes--Testis: If the patient received chemo, should "bulky retroperitoneal adenopathy" be coded as involved lymph nodes in the EOD lymph node involvement field for a testicular primary treated with an orchiectomy that rendered a path diagnosis of "seminoma confined to the testicle"? See discussion. | Per an orchiectomy path diagnosis a seminoma was confined to the testicle. The only other workup, other than a scrotal ultrasound, was a staging CT scan that revealed bulky retroperitoneal adenopathy in abdomen and pelvis, as well as mediastinal adenopathy. There was also a peripheral pulmonary nodule. No final clinical diagnosis or stage was provided in the chart. Following the orchiectomy the patient was treated with chemo. Should we also have coded distant site lung involvement? | For cases diagnosed 1998-2003, code the EOD-Lymph Nodes field to 9 [unknown] because "adenopathy" is not used to code lymph node involvement. The physician varied from the usual treatment for a localized testicular carcinoma, which is an orchiectomy. The physician proceeded immediately to chemotherapy as further treatment. It is not clear whether the decision to treat with chemo was based on the nodes and/or lung being involved.
Search the record for the physician's opinion regarding distant metastasis. Do not code distant involvement based on a peripheral pulmonary nodule seen on CT without further proof. If no further information is available, code the EOD-Extension field to 99. |
2002 |
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20020063 | EOD-Extension--Breast: How do we interpret "dermal lymphovascular space invasion" and "dermal lymphovascular invasion" for extension? See discussion. | A breast path report states tumor invades dermal lymphovascular spaces. Also, pathologists sometimes state "dermal lymphovascular invasion". Are both these terms synonymous with dermal lymphatic invasion? | For cases diagnosed 1998-2003:
Dermal lymphovascular invasion and tumor in dermal lymphatics would both be coded as dermal lymphatic invasion. |
2002 |