04-17-2026 Where in the Small Intestine is that?
Scenario:
- Laparoscopic Small Bowel Resection: Small bowel stricture 50 cm proximal to the ileocecal valve. It was firm and hard. No other pathology was noted
- Pathology:
- Procedure: Segment resection, small intestine
- Tumor Site: Small intestine, not otherwise specified
- Histologic Type and Grade: G1, Well Differentiated Neuroendocrine Tumor
Question: How would you code primary site?
- 2 Ileum
- 9 Small intestine, NOS
Answer: C17.2 Ileum
Discussion & Rationale – The operative report takes priority over the pathology report when determining tumor location.1 In this case, the operative note clearly documents a firm, hard stricture located 50 cm proximal to the ileocecal valve.
According to the SEER Glossary of Terms2 for the small intestine, a lesion 50 cm proximal to the ileocecal valve falls within the ileum. Therefore, based on the operative description and confirmed by SEER anatomic definitions, the stricture should be classified as occurring in the ileum.
1 SEER Program Coding and Staging Manual: Physician Priority Order for Coding Primary Site for Solid Tumor https://seer.cancer.gov/tools/codingmanuals/
2SEER’s Glossary for Registrars: https://seer.cancer.gov/seertools/glossary/
