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Centers for Disease Control and Prevention Division of Cancer Prevention and Control 4770 Buford Hwy, NE MS K-64 Atlanta, GA 30341-3717 Call: 1 (800) CDC-INFO TTY: 1 (888) 232-6348 FAX: (770) 488-4760 E-mail: cdcinfo@cdc.gov Submit a Question Online |
Brain Tumor Registry Reporting Training Materials
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Date of Clarification: March 27, 2006
Q: Is it possible for a benign schwannoma to arise on the spinal cord or does one always arise from nerve roots coming off the cord? Example: The medical record indicates a C2-C3 schwannoma. Is this a reportable neoplasm?
A: Anatomically, schwannomas must be derived from Schwann cells which are not a part of the CNS; therefore, they must all come from peripheral nerves, and as such come from nerve roots. The definition of reportable non-malignant sites includes the spinal cord (C72). It does not include "spinal nerves" (C47) consequently, schwannomas of the spinal cord area are NOT REPORTABLE.
Q: If the surgeon states "resection of intradural extramedullary schwannoma." does this mean that the tumor is outside the cord but within the dura?
A: Yes, but it also means it is on a peripheral nerve root and therefore is NOT REPORTABLE.
Q: Are vestibular schwannomas reportable?
A: Vestibular schwannomas, also known as acoustic neuromas, arise from the VIIIth cranial nerve (C72.4). Tumors of the cranial nerves ARE REPORTABLE. Code these tumors to acoustic nerve C72.4 M-9560/0.
Q: Are cerebellopontine angle tumors reportable?
A: Cerebellopontine angle schwannomas are VIIIth cranial nerve schwannomas, and as such, ARE REPORTABLE. However, cerebellopontine angle tumors also included meningiomas and epidermoids, so you must have histologic verification to code them correctly.
Q: Is a schwannoma of the face reportable?
A: Subcutaneous or intramuscular schwannomas including those on the face or neck, arise from a peripheral nerve root. Therefore, they are NOT REPORTABLE.
Date of clarification: July 2004
Q: Are non-malignant blood vessel tumors occurring in CNS sites reportable?
A: YES: The CNS site/histology listing includes blood vessel tumors under several categories including meninges C70.0 -C70.9, brain C71.0-C71.4 and C71.7-C71.9, (excluding ventricle), spinal cord C72.0, cauda equina C72.1, cranial nerves C72.2-C72.5, cerebellum C71.6 and other nervous system C72.8-C72.9.
These tumors include
Q: Should blood vessel tumors occurring in CNS sites be coded to blood vessel or CNS?
A: They should be coded to the CNS site in which they occur.
This follows the same rationale that if you have a lymphoma of the brain, it is coded to "brain," not lymph node.
Example: Patient is diagnosed with a hemangioblastoma of the right temporal lobe of the brain. Site code: C71.2, histology code: 9161/1 Laterality: Right only.
Angiosarcomas are exceedingly rare and occur in the "brain" parenchyma.
Hemangiopericytomas are not rare tumors and occur almost entirely attached to the dura (meninges).
There have been rare case reports of Hemangioendotheliomas of the brain. They occur anywhere in the brain and dura.
Date of clarification: March 2004
Examples:
Example: Patient has a benign cerebral meningioma, NOS over the left parietal lobe. Site code: C70.0; Laterality: Left only, M9530/0. The patient is subsequently diagnosed with a benign cerebral meningioma, NOS also on the left side of the brain. Site code: C70.0; Laterality: Left only; M9530/0. Because these tumors are in the same site (C70.0), same histology (M9530/0), and located on the same side of the brain, they are considered the same primary tumor regardless of the timing of the diagnosis. Only one abstract should be completed.
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