Summary Stage 2018: Merkel Cell Carcinoma

Summary Stage 2018

Notes

**Merkel Cell Carcinoma (8041, 8190, 8247)** C000-C006, C008-C009, C440-C449, C510-C512, C518-C519, C600-C602, C608-C609, C632, C809 C000 External upper lip C001 External lower lip C002 External lip, NOS C003 Mucosa of upper lip C004 Mucosa of lower lip C005 Mucosa of lip, NOS C006 Commissure of lip C008 Overlapping lesion of lip C009 Lip, NOS C440 Skin of lip, NOS C441 Eyelid C442 External ear C443 Skin of other and unspecified parts of face C444 Skin of scalp and neck C445 Skin of trunk C446 Skin of upper limb and shoulder C447 Skin of lower limb and hip C448 Overlapping lesion of skin C449 Skin, NOS C510 Labium majus C511 Labium minus C512 Clitoris C518 Overlapping lesion of vulva C519 Vulva, NOS C600 Prepuce C601 Glans penis C602 Body of penis C608 Overlapping lesion of penis C609 Penis C632 Scrotum, NOS C809 Unknown primary site **Note 1:** The following sources were used in the development of this schema * SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998) (https://seer.cancer.gov/archive/manuals/EOD10Dig.3rd.pdf) * SEER Summary Staging Manual-2000: Codes and Coding Instructions (https://seer.cancer.gov/tools/ssm/) * Collaborative Stage Data Collection System, version 02.05: https://cancerstaging.org/cstage/Pages/default.aspx * Chapter 46 *Merkel Cell Carcinoma*, in the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing. Used with permission of the American College of Surgeons, Chicago, Illinois. **Note 2:** Merkel cell carcinoma presenting in nodal or visceral site with primary site unknown is coded to C449, Skin, NOS. **Note 3:** See the chapter (schema) corresponding to the primary site for information about regional nodes. For example: For primary Anus Merkel cell, see the anus chapter (schema) for regional nodes information. • C210 Anus • C300 Nasal cavity and Ethmoid Sinus • C500 Breast (nipple) • C510-C512, C518-C519 Vulva • C600-C602, C608-C609 Penis • C632 Scrotum (Male Genital Other)

NAACCR Item

NAACCR #764
SS2018 Description
0 In situ, intraepidermal, intraepithelial, noninvasive
1 Localized only (localized, NOS) - Confined to site of origin - Lesion(s) confined to dermis - Subcutaneous tissue (through entire dermis
2 Regional by direct extension only - Bone - Cartilage - Fascia - Skeletal muscle
3 Regional lymph node(s) involved only - Skin (C440-C449) - Single, Multiple, Ipsilateral, Bilateral or Contralateral lymph node(s) - Head and Neck + All subsites: Cervical - Lip + Facial (buccinator, buccal, nasolabial) + Mandibular (submandibular, submaxillary, NOS) + Parotid (infra-auricular, preauricular, NOS) + Submental - External ear/auditory canal + Mastoid (post-/retro-auricular) (occipital) + Preauricular - Face, Other (cheek, chin, forehead, jaw, nose and temple) + Facial (buccinator, buccal, nasolabial) + Mandibular (submandibular, submaxillary, NOS) + Parotid (infra-auricular, preauricular, NOS) + Submental - Scalp + Mastoid (post-/retro-auricular) (occipital) + Parotid (infra-auricular, preauricular, NOS) + Spinal accessory (posterior cervical) - Neck + Axillary + Mandibular, NOS + Mastoid (post-/retro-auricular) (occipital) + Parotid (infra-auricular, preauricular, NOS) + Spinal accessory (posterior cervical) + Submental + Supraclavicular (transverse cervical) - Upper Trunk + Axillary + Cervical + Internal mammary (parasternal) + Supraclavicular (transverse cervical) - Lower Trunk + Femoral (superficial inguinal) - Arm/Shoulder + Axillary + Epitrochlear for hand/forearm + Spinal accessory for shoulder - Leg/Hip + Femoral (superficial inguinal) + Popliteal for heel and calf - Vulva (C510-C512, C518-C519) + Deep inguinal, NOS + Femoral + Inguinal, NOS + Inguinofemoral (groin) + Node of Cloquet or Rosenmuller (highest deep inguinal) + Superficial inguinal (femoral) - Penis (C600-C602, C608-C609) + Iliac, NOS * External * Internal (hypogastric, obturator) + Inguinal, NOS * Node of Cloquet or Rosenmuller (highest deep inguinal) * Superficial [femoral] + Pelvic, NOS - Scrotum (C632) + Iliac, NOS * External * Internal (hypogastric), NOS - Obturator + Inguinal, NOS * Deep inguinal, NOS - Node of Cloquet or Rosenmuller (highest deep inguinal) * Superficial inguinal (femoral) - Regional lymph node(s), NOS + Lymph node(s), NOS
4 Regional by BOTH direct extension AND regional lymph node(s) involved - Codes (2) + (3)
7 Distant site(s)/lymph node(s) involved - Distant site(s) (including further contiguous extension) + Bone + Cartilage + Fascia + Lung + Other visceral sites + Skeletal muscle (excluding direct extension) + Skin or subcutaneous tissue beyond regional lymph nodes + Underlying cartilage - Distant lymph node(s), NOS + Axillary (lower trunk) + Femoral (cephalad/caudal) (upper trunk) + Iliac (leg/hip) + Supraclavicular (head and neck, arm/shoulder) - Distant metastasis, NOS + Carcinomatosis + Distant metastasis WITH or WITHOUT distant lymph node(s)
9 Unknown if extension or metastasis
(1) Fritz AG, Ries LAG (eds). **SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998)**, National Cancer Institute, NIH Pub. No. 98-2313, Bethesda, MD, 1998 (2) Young JL Jr, Roffers SD, Ries LAG, Fritz AG, Hurlbut AA (eds.). **SEER Summary Staging Manual-2000: Codes and Coding Instructions**, National Cancer Institute, NIH Pub. No. 01-4969, Bethesda, MD, 2001. (3) Collaborative Stage Work Group of the American Joint Committee on Cancer. **Collaborative Stage Data Collection System User Documentation and Coding Instructions, version 02.05**. American Joint Committee on Cancer (Chicago, IL) (4) Gress, D.M., Edge, S.B., Gershenwald, J.E., et al. **Principles of Cancer Staging**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 3-30 (5) Bichakjian, C.K., Nghiem, P., Sober, A.J., et al. **Merkel Cell Carcinoma**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 549-562