Metastatic disease versus recurrent endometrial

KMayercsik

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I have a patient treated with radiation 2019 for endometrial cancer. She was s/p TLH/BSO at that time and is back and per the physician with:
Recurrent endometrial adenocarcinoma to the vaginal cuff (initial diagnosis 01/2021: stage
IA, no myometrial invasion, grade 1)

Is this a metastatic process of endometrial to the vaginal cuff (C79.82) or endometrial cancer (C54.1). It's recurring at the vaginial cuff.
Thanks in advance.
 

thomas7331

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It's confusing wording to me. On the one hand, it sounds like a metastasis of the endometrial cancer, but on the other hand, stage 1A suggests that it has not spread to other sites, which sounds like a primary tumor. But that seems contradictory since if it's vaginal tissue, I'd think it wouldn't be endometrial cancer.

I think this is a clinical question rather than a coding question. I'm not a physician and wouldn't want to be the one to make the conclusion one way or the other. I think that it would be best to query the physician for clarification.
 
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trarut

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Recurrent disease is not metastatic disease. If it was metastatic, the pathologist would have labeled it that in the report. It's much the same as recurrent breast cancer presenting in the chest wall - it's not metastatic disease, it's considered an active primary site. There's nothing wrong with querying the oncologist or the surgeon but I would not hesitate to code it using C54.1.
 
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