Program Operations Manual System (POMS)
TN 36 (09-20)
DI 23022.305 Small Cell Cancer of the Ovary
COMPASSIONATE ALLOWANCES INFORMATION
|
SMALL CELL (OAT CELL) CANCER OF THE
OVARY
|
ALTERNATE NAMES
|
Cancer of the Ovary; Small Cell Carcinoma of the Ovary; SCCO
|
DESCRIPTION
|
Small Cell Cancer of the Ovary is an extremely rare type of ovarian cancer that is distinguished from other ovarian
epithelial and ovarian germ cell tumors. It is divided into two types, the hypercalcemic
and the pulmonary type, of which the latter is extremely rare. Small cell cancer of
the ovary tends to occur in young women (under 40 years of age).
|
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
|
Diagnostic testing: There is no standard or routine screening test for small cell cancer of the ovary.
Pelvic exam, transvaginal ultrasound may detect ovarian cancer. Biopsy is the primary
method of diagnosis and staging of the disease.
Physical findings: Symptoms of small cell cancer of the ovary are often subtle. They may include:
-
•
Persistent bloating or increased abdominal size;
-
•
Pelvic or abdominal pain;
-
-
-
-
-
-
-
•
Menstrual irregularities.
ICD-9: 789.51, 795.82
ICD-10: R97.1
|
PROGRESSION
|
Small Cell Cancer of the Ovary is a highly aggressive tumor. Metastatic tumor occurs
mostly within the pelvis and abdomen, but hematogenous spread also occurs. Only one-third
of patients with stage Ia disease have disease-free follow-up periods and almost all
patients with higher stage tumors die of disease, usually within 2 years.
|
TREATMENT
|
The primary form of treatment for Small Cell Cancer of the Ovary is surgery with chemotherapy
or radiotherapy, depending on the stage of the disease. Effective treatment of patients
with high-stage tumors or recurrent disease has not been achieved; although rare,
patients with high stage tumors have survived over 4 years after intensive chemotherapy,
radiation therapy, or both.
|
SUGGESTED
PROGRAMMATIC ASSESSMENT* |
Suggested MER for Evaluation:
-
•
A pathology report of a biopsy specimen from the ovary showing small cell cancer.
There is no substitute for pathology.
|
Suggested Listings for Evaluation: |
DETERMINATION |
LISTING
|
REMARKS |
Meets |
13.23 F |
Small Cell Cancer of the Ovary meets the criteria in 13.23 F with a diagnosis supported
by biopsy.
|
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.
|