ALTERNATE NAMES
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Osteogenic Sarcoma; Chondroblastic Osteocarcoma; Multifocal Osteosarcoma; Metastatic
Osteosarcoma; Fibroblastic Osteosarcoma; Central Osteosarcoma; Conventional Central
Osteosarcoma; Classical Osteosarcoma; Osteoblastic Sarcoma; Central Osteogenic Sarcoma;
Sclerosing Osteosarcoma
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DESCRIPTION
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Osteosarcoma is the most common bone cancer in children and adolescents, with peak onset in the
second decade. It tends to occur in the long bones (particularly distal femur, proximal
tibia, and proximal humerus), but can occur in any bone. The lungs are the most common
site of metastasis. Kidneys, adrenal gland, brain, and heart can also be sites of
metastasis.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING
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Diagnostic testing: Diagnostic testing for osteosarcoma includes:
Physical findings: The signs and symptoms of osteosarcoma may include:
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Swelling or pain at site of tumor or with activity;
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Limping (if tumor is in leg);
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Limitation of motion of the affected area; and
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ICD-9: 170
ICD-10: C41.9
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PROGRESSION
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The prognosis of osteosarcoma depends on age at presentation, the extent of the disease
(size and location of tumor, presence or absence of metastasis), and the response
to therapy. Long-term survival rates are better if the cancer has not spread to the
lungs (pulmonary metastasis). If the cancer has spread to other parts of the body,
prognosis is better and there is still a chance of cure with effective treatment.
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TREATMENT
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Treatment may include chemotherapy, radiation, surgery, bone grafting, limb-amputation,
and limb-saving (salvage) surgery.
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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/biopsy report of the cancer; and
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Treatment records including surgical procedures, and up-to-date progress notes.
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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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13.11 A
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Osteosarcoma that is inoperable or unresectable meets listing 13.11 A.
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13.11 C
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Osteosarcoma that has distant metastases meets listing 13.11 C.
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13.11 D
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Osteosarcoma in adults treated with multimodal therapy meets 13.11 D without regard
to effectiveness of treatment.
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113.03 A or B
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Pediatric osteosarcoma meets 113.03 (solid tumors); only a pathology report is needed.
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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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