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For cases diagnosed 1998-2003:

Code the Behavior Code and the EOD-Extension field according to the pathology report.

If the pathology report states the tumor to be noninvasive or in situ, whether or not von Brunn nests are involved, code behavior as 2 [in situ] and extension as in situ.

If the tumor is described as invasive and involves the von Brunn nests, code the EOD-Extension field to 15 [invasive tumor confined to subepithelial connective tissue] because code 15 includes extension to the lamina propria and von Brunn nests are within the lamina propria.

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 60. Code 60 is defined as a brain tumor that extends into the meninges. It is also the appropriate code to use for a tumor that extends from the meninges to the brain.

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 cases diagnosed prior to 1/1/2010:Code the Grade, Differentiation field to 5 [T-cell] in the 6th digit of the ICD-O-3 morphology field when the terms "pre-T cell" or "T-precursor" are used. However, this is not an official change to ICD-O-3.

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.

For cases diagnosed 2007 or later:

Assuming ductal carcinoma in situ and invasive lobular carcinoma are present in a single tumor, code 8520/3 [Infiltrating lobular carcinoma, NOS].

Using the 2007 MP/H rules for breast, the single tumor invasive and in situ carcinoma module, start and stop at rule H9 and code the invasive histology.

For cases diagnosed 1998-2003:

Code the EOD Clinical Extension field to 30-34 when there is no documentation saying that the physical examination was negative.

For tumors diagnosed prior to 2007:

Yes. This case is reportable as a second primary. The rule in the SEER Program Code Manual says that invasive bladder cancers with histology codes 8120-8130 [papillary, transitional] are always coded as a recurrence and are an exception to the multiple primary rule. Squamous cell carcinoma [8070] is not a part of that exception.

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 1/1/2003 to 12/31/2010: Code Zoladex (gosrelin) and Lupron (leuprolide acetate) as 01 [Hormone therapy administered as first course therapy] only when stated to be given as part of the first course of cancer-directed therapy. If you do not know whether these drugs were given to preserve ovarian function or as an adjunct to chemotherapy (i.e, there is no treatment plan), do not code as Hormonal treatment given.

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 999 [unknown] for this case because this field is supposed to reflect the dimension for tumor width and not tumor depth. Tumor depth is coded in the EOD-Extension field.

The criteria for AJCC stage T2 consists of both size and tumor extension values. Size of tumor is recorded in the EOD-Size of Primary Tumor field. If you determine that size is the physician's sole criteria for assigning a T2 value, code an EOD-Extension value that reflects more specific information than 30 [localized, NOS]. Code to 10 or 25, depending on the case.

If the tumor size is not provided, and there is only a clinician statement that describes the lung tumor as a stage T2, code EOD-Extension to 20, the numerically lowest equivalent EOD-Extension code for the lung T2 category.