Tumor Tip of the Week-05-26-2023 CRM-Don’t forget the Gross!

05-26-2023 CRM Don’t forget the Gross!

Scenario 2023:  Colon Cancer

• The Synoptic report stated this:
• Margin Status for Invasive Carcinoma:  All margins negative for invasive carcinoma 
• Closest Margin(s) to Invasive Carcinoma:   Proximal
• Distance from Invasive Carcinoma to Closest Margin: 1.8 cm

[Tip: Review the GROSS Section of the path report, often it will contain the information you need to code the SSDI Circumferential Margin if it missing from the synoptic report.]

Upon sectioning, the tumor extends through the full-thickness of the wall and superficially invades the pericolonic fat.  It is 2 cm from the radial sidewall resection margin. 

GROSS DESCRIPTION

Question:  How will assign the SSDI Circumferential Margin?

• 002
• 020
• XX.1
• XX.9

Answer:  020 [2cm from radial margin =2×10=20mm]

Rationale:

• SSDI Manual Circumferential Margin
  • Note 5: The CRM may be referred to as
    • Circumferential radial margin
    • Circumferential resection margin
    • Mesenteric (mesocolon) (mesorectal) margin
    • Radial margin
    • Soft tissue margin
  • Note 7: If the value is recorded in Centimeters, multiply by 10 to get the value in Millimeters (mm).
    • Example: CRM recorded as 0.2 cm. Multiply 0.2 x 10 and record 2.0