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9. See the site-specific coding guidelines in SEER Appendix C for primary site coding guidelines for the following sites:

10. See section below for primary site coding guidelines for sarcoma

11. Angiosarcoma

a. Code C422 (spleen) as the primary site for angiosarcoma of spleen

b. Code C50_ (breast) for angiosarcoma of breast. Although angiosarcoma actually originates in the lining of the blood vessels, an angiosarcoma originating in the breast has a poorer prognosis than many other breast tumors.

12. Gastrointestinal Stromal Tumors (GIST): Code the primary site to the location where the GIST originated

13. Transplants

a. Code the primary site to the location of the transplanted organ when a malignancy arises in a transplanted organ, i.e., code the primary site to where the malignancy resides or lies

Example: There is a diagnosis of malignancy in transplanted section of colon serving as esophagus. Code the primary site as esophagus. Document the situation in a text field.

b. For additional information about hematopoietic-related transplants, refer to the Hematopoietic and Lymphoid Neoplasm Coding Manual and Database.

14. Assign primary site code C449, skin NOS, for a Merkel cell carcinoma presenting in a nodal or distant metastatic site and site of origin is unknown

15. In the absence of any additional information about the primary site, assign the codes listed for these primary sites/histologies

16. When the medical record does not contain enough information to assign a primary

a. Consult a physician advisor to assign the site code

b. Use the NOS category for the organ system or the Ill-Defined Sites (C760-C768) if the physician advisor cannot identify a primary site

Occult Tumors of the Head and Neck

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