SEER Inquiry System - Search

For tumors diagnosed prior to 2007:

Example 1: Code the Histology and Grade, Differentiation fields to 8140/39 [adenocarcinoma, NOS, grade not stated]. Because there was no microscopic examination of tissue from the primary site, the histology may be coded from the microscopic examination of the tissue from a metastatic site. Do not code grade from a metastatic site regardless of whether the involvement of the metastatic site is by direct extension or by discontinuous metastases.

Example 2: Code the Histology and Grade, Differentiation fields to 8046/33 [non-small cell carcinoma, poorly differentiated]. Because there is a microscopic examination of tissue from the primary site, that information should be used to code histology rather than a cytology of a metastatic site.

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.

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 10 [confined to pancreas] because a scan supported the finding of no extension beyond the pancreas.

If the abstractor reviewing the medical record has scans, op reports, and/or pathology reports stating that the tumor is confined to the pancreas, code extension to 10 [confined to pancreas].

However, if the medical record only provides a patient history from a physician stating that the patient had localized pancreas, code extension to 30 [localized, NOS]. The NOS codes are used only when there is not enough information to code the specific codes (in this case, 10 or 20).

For cases diagnosed 1998-2003:

Generally, code the EOD-Size of Primary Tumor field to the largest size identified in any scan. Use the largest tumor size for most cases. There is no hierarchy for multiple imaging studies, with the exception of the two situations represented in the question examples.

1). Code the size stated on the mammogram, even if that size is smaller than the one specified on the ultrasound. Generally the mammogram size is more accurate for breast cases than ultrasound.

2). Code the EOD-Size of Primary Tumor field to 2.5 cm. In this example, the second scan was the same type as the first. Usually there is not that much of a difference in size between the same tests, unless the tumor has an aggressive histology. The example does not mention the histology. With certain histologies, such as small cell of the lung, a rapid growth in a short amount of time is the normal process. The fact that the size increased that much in a short period of time, using the same type of scan, is an indication of a rapidly growing tumor. It would be better to use the size on the initial scan to code the EOD-Size of Primary Tumor.

For tumors diagnosed 2004 to 2006:

The terminology "Architectural pattern: ____________," when used in the final pathology diagnosis, indicates a subtype that can be coded. This type of format in a pathology report is based on a College of American Pathologists (CAP) protocol. Disregard "pattern" and "architecture" when not used in accordance with the CAP protocol. See www.cap.org for cancer protocols.

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.

For tumors diagnosed prior to 2007:

Code the Date of Diagnosis to March. Code the Histology field to 8500/3 [Infiltrating duct carcinoma]. Histology can be upgraded from a clinical histology to a pathological histology anytime.

For cases diagnosed 1998-2003, in coding extension, you need to assess whether there has been progression of disease or not. If progression of disease is verified, do not code extension using the surgical information from November. Code the extension and tumor size based on the mammogram and physical examination at the time of the mammogram, if available.

If no progression of disease is verified, use surgical information to code extension and tumor size.

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.

For cases diagnosed January 2004 and forward:

1) Grade 4. High grade is coded 4. Code the grade stated in the final diagnosis.

2) Grade 3. Grade 1-2/3 is coded 3. Use the three-grade conversion table in the 2004 SEER manual.

3) Grade 4. Grade 3 of 3 is coded 4. Use the three-grade conversion table in the 2004 SEER manual.

4) Grade 3. "Grade 3 out of 4" is coded 3 and is more precise than "high grade."

For cases diagnosed 1998-2003:

Do not include the spinal metastasis because it was diagnosed after the extent of disease was established. If metastasis was not present at diagnosis, and not discovered during the original metastatic work-up, it is progression of disease.

The code for retinoic acid depends upon the primary site and histology of the tumor. Code retinoic acid (also called Vitamin A, tretinoin, ATRA, all-transretinoic acid or Vesanoid) in the Immunotherapy field as 01 [Immuno administered as first course therapy] for acute promyelocytic leukemia. This drug is given to patients as an alternative to chemotherapy.

For all other sites/histologies, code retinoic acid in the Other Cancer-Directed Therapy Field. Use code 2 [Other experimental cancer-directed therapy] or 3 [Double-blind clinical trial, code not yet broken] if the drug is given as part of a protocol. If the drug is not being given as part of a protocol or you don't know whether it is part of a protocol, use code 1 [Other cancer-directed therapy].