Summary Stage 2018: Merkel Cell Skin
Summary Stage 2018
Notes
**Merkel Cell Skin** 8041, 8190, 8247 (C000-C006, C008-C009, C440-C449, C510-C512, C518-C519, C600-C602, C608-C609, C632, C809) **Note 1:** The following sources were used in the development of this chapter * 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:** Lymph nodes with isolated tumor cells (ITCs) are counted as positive lymph nodes. ITCs are defined as any tumor deposits in lymph nodes less than or equal to 0.2 mm. **Note 3:** Merkel cell carcinoma presenting in nodal or visceral site with primary site unknown is coded to C449, Skin, NOS.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 - All sites + Regional lymph node(s), NOS * Lymph node(s), NOS - Skin of head and neck (C000-C006, C008-C009, C440-C444) + Levels I-VII + Axillary (neck only, C444) + Cervical, NOS + Deep cervical, NOS + Facial (buccinator, buccal, nasolabial) + Internal jugular, NOS + Parapharyngeal + Parotid (infraauricular, intraparotid, periparotid, preauricular) + Retroauricular (mastoid) + Retropharyngeal + Suboccipital - Skin of upper limb and shoulder (C446) + Axillary + Cervical + Epitrochlear for hand/forearm + Internal mammary (parasternal) + Spinal accessory for shoulder + Supraclavicular (transverse cervical) - Skin of lower limb and hip (C447) + 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) |
| 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 |