TN 61 (10-23)

DI 23022.185 Glioblastoma Multiforme (Adult Brain Cancer)

COMPASSIONATE ALLOWANCES INFORMATION

GLIOBLASTOMA MULTIFORME (ADULT BRAIN CANCER)

ALTERNATE NAMES

Glioblastoma; Glioblastoma Adult Brain Tumor; GBM; Grade IV astrocytoma; Diffuse Midline Glioma; H3K27M-Mutant; Giant Cell Glioblastoma; Gliosarcoma; Gliosarcoma, IDH Wildtype; Glioblastoma, IDH Wildtype; Glioblastoma, IDH Mutant; Glioblastoma, NOS

DESCRIPTION

Glioblastoma Multiforme is a fast-growing type of central nervous system cancer that forms from glial (supportive) tissue of the brain and spinal cord and has cells that look very different from normal cells. It spreads aggressively throughout the brain tissue and is the most malignant of the primary brain cancers. In consequence, these cancers are difficult to treat and often recur after initial therapy. Glioblastoma multiforme most often occurs in adults between the ages of 45 and 70 years and affects the brain more often than the spinal cord.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9–CM/ICD-10-CM CODING

Diagnostic testing: Diagnosis is based on:

  • Patient history;

  • Neurological examination; and

  • Diagnostic procedures.

The only definitive test that can provide a diagnosis of glioblastoma is a biopsy of the cancer. Testing to confirm diagnosis of glioblastoma includes neuroimaging (CT and MRI) to provide information about the location, size and shape of the cancer.

Physical findings: Individuals with this impairment may present with:

  • Slowly progressive neurologic deficits;

  • Motor weakness; Increased intracranial pressure including headaches, nausea, and vomiting, and cognitive impairments;

  • Changes in mood and personality; and

  • Seizures.

ICD-9: 191.9

ICD-10: C71.9

PROGRESSION

Glioblastoma multiforme is highly aggressive, infiltrating, and responds poorly to all currently available treatments. The prognosis is grim, as most patients die within 2 years and few survive longer than three years.

TREATMENT

Treatment of glioblastoma multiforme may include the following: surgery, radiation and/or chemotherapy.

SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested Listings for Evaluation:
  • Pathology report of the cancer biopsy or surgical specimen is the critical information necessary for disability evaluation;

  • Clinical history and examination that describes the diagnostic features of the impairment;

  • Pathology reports;

  • Operative reports; and

  • Results of neuroimaging (e.g. CT scan, MRI scan).

Suggested Listings for Evaluation:
DETERMINATION

LISTING

REMARKS
Meets 13.13 A 1

113.13 A

Equals
* 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.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022185
DI 23022.185 - Glioblastoma Multiforme (Adult Brain Cancer) - 10/05/2023
Batch run: 10/05/2023
Rev:10/05/2023