SOFT TISSUE
SARCOMA - WITH DISTANT
METASTASES OR RECURRENT
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ALTERNATE NAMES
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Malignant Soft Tissue Sarcoma; Malignant Soft Tissue Tumor; Malignant Mesenchymal
Tumor ; Mesenchymal Sarcoma
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DESCRIPTION
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Soft Tissue Sarcoma is cancer that develops in the connective tissues (e.g. skeletal muscles, tendons,
fat, fibrous tissues, deep skin tissues, and blood vessels) and the peripheral nervous
system. Adult soft tissue sarcomas can form almost anywhere in the body, but are more
common in the head, neck, arms, legs, trunk, and abdomen. In children, the tumors
form most often in the arms, legs, or trunk (chest and abdomen). The exact cause of
soft tissue sarcoma is unknown. Individuals with environmental exposure to high levels
of some chemicals, radiation, or have certain genetic conditions may be at risk for
developing soft tissue sarcoma. Soft Tissue Sarcoma with
distant metastases or recurrent is considered an aggressive tumor because it often quickly spreads from the original
site to other parts of the body such as lungs and lymph nodes.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing: The definitive diagnosis of soft tissue sarcoma is based on:
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Immunohistochemistry, cytogenic and molecular studies;
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Frozen section and intraoperative cytology;
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Fluorescence in situ hybridization (FISH); and
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Biopsy reports are definitive.
Physical findings: The physical findings are dependent upon the location of the tumor mass and may include
localized pain; swelling and warmth at the site of the tumor; fever; and unexplained
weight loss.
ICD-9: 171.X and other codes, depending upon the site
ICD-10: C49
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PROGRESSION
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The prognosis of soft tissue sarcoma depends on the type of soft tissue sarcoma; the
size of the tumor at first diagnosis; location of the tumor and spread (metastasis)
to other organs; whether all of the tumor is removed by surgery; age of the individual;
and recurrence. The rate at which these tumors grow is variable. Soft tissue sarcomas
are generally large at the time of first diagnosis because they tend not cause any
symptoms, until the tumor starts to push aside normal tissue, creating lumps, swelling
and other symptoms such as pain or soreness. When soft tissue sarcomas spread to other
sites (metastasize) they can have a poor prognosis.
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TREATMENT
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The treatment of soft tissue sarcomas are based on clinical presentation of local
vs. metastatic disease. The main treatment of soft tissue sarcoma is surgery, chemotherapy,
and radiation, virtually always used in combination.
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SUGGESTED PROGRAMMATIC ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Pathology reports of biopsy.
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Suggested Listings for Evaluation:
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DETERMINATION
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LISTING
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REMARKS
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Meets
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13.04 A or B
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Listing level severity must be documented. To meet the criteria in listing 13.04,
the cancer must have regional or distant metastases (13.04 A), or be recurrent following
initial antineoplastic therapy (13.04 B).
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113.03
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Listing level severity must be documented. |
Equals
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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