Review: Abstracting, Coding, and Staging Brain & CNS Tumors

Here is what we have learned from Abstracting, Coding, and Staging Brain & CNS Tumors:

• Brain and CNS cancer is the leading cause of cancer-related death in patients younger than age 35 in this country.
• A benign CNS tumor can be just as dangerous over time as a malignant one if it begins to press on a vital area of brain tissue.
• Brain cancer symptoms depend very much on the size of the cancer and where it is located within the brain.
• Neurons are the conducting cells of the nervous system; glial (neuroglia) cells do not conduct nerve impulses, but instead, they support, nourish, and protect the neurons.
• Major categories of brain tumor based on WHO classification are:
  • Tumors of neuroepithelial tissue
  • Tumors of peripheral nerves
  • Tumors of meninges
  • Tumors of sellar region
  • Germ cell tumors
  • Lymphomas
  • Metastatic tumors
• In addition to ICD-O-3 morphology code, other grading systems used to describe CNS tumors are WHO grade, Kernohan grade, and St. Anne/Mayo grade.
• Basically, all brain tumors are considered localized unless they cross the midline or the tentorium or unless they are described as having "drop" metastases in the spinal cord.
• Brain tumors can be staged with SEER Summary Stage and Collaborative Stage; TNM staging for brain tumors was withdrawn from 5th and 6th editions.
• In determining multiple primaries, separate rules are used for non-malignant and malignant brain tumors in terms of timing, primary site, Laterality, and Histology.
• The sequence number indicates the sequence of all reportable neoplasms over the lifetime of the patient and it is recorded in the sequence number data field.
• Generally the treatment of choice is surgery unless the tumor is in an inaccessible or delicate area.