Program Operations Manual System (POMS)
TN 36 (09-20)
DI 23022.311 Small Cell Cancer of the Thymus
COMPASSIONATE ALLOWANCES INFORMATION
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SMALL CELL (OAT CELL) CANCER OF THE
THYMUS
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ALTERNATE NAMES
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Thymic Small Cell Carcinoma; Small Cell Carcinoma of the Thymus
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DESCRIPTION
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Small Cell Cancer of the Thymus is a rare aggressive type of cancer in which malignant cancer cells form on the outside
surface of the thymus. The thymus is a small organ that is located behind the breast
bone (sternum) in the front part of the mediastinum, the space in the chest between
the lungs. This type of cancer is among the rarest cancer in humans, comprising of
<1% of all adult cancers. The exact cause of this cancer is unknown. These cancers
are often associated with autoimmune diseases (i.e. myasthenia gravis, polymyositis,
lupus erythematous, rheumatoid arthritis, thyroiditis, Sjogren's syndrome and hypogammaglobulinemia).
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic
testing:
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Medical history and examination;
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Imaging tests such as chest x-ray, CT scan and MRI scan;
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Needle biopsy or surgical biopsy.
Physical findings: The thymus is located near the superior vena cava, the main blood vessel that brings
blood from the head and upper body to the heart. Tumors that press on this vessel
may cause:
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Swelling in the face, neck, and upper chest;
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People may have a bluish color on the upper body;
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Swelling of the visible veins in the upper body;
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Reports of dizziness or light-headedness.
ICD-9: 164.0
ICD-10: C37
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PROGRESSION
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Small cell cancers of the thymus tend to grow fast and spread (metastasize) to other
parts of the body and they have a high risk of recurrence. The prognosis is poor,
as it is with all small-cell carcinomas.
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TREATMENT
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This type of cancer is generally treated with surgery to remove the tumor, radiation,
and chemotherapy. Chemotherapy may be prescribed prior to surgical resection to shrink
the size of the tumor.
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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;
and
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Pathology report of a biopsy or surgical specimen of the thymus showing small cell
histology.
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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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113.03
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Small Cell Cancer of the Thymus is rare in children.
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13.15 C |
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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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