Program Operations Manual System (POMS)
TN 45 (08-21)
DI 23022.382 Desmoplastic Mesothelioma
COMPASSIONATE ALLOWANCES INFORMATION
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DESMOPLASTIC MESOTHELIOMA
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ALTERNATE NAMES
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Desmoplastic Malignant Mesothelioma; DMM
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DESCRIPTION |
Desmoplastic Mesothelioma is a rare and highly aggressive cancer that most commonly occurs in the pleura, the
membranous enclosures surrounding the lungs. It occasionally originates in the linings
of the heart (pericardium) and visceral organs (peritoneum). The term “desmoplastic”
refers to the signature masses of fibrous connective tissue produced in affected areas.
Unlike other subtypes of mesothelioma, the desmoplastic variant is not as closely
linked to asbestos; less than 20% of cases involve confirmed asbestos exposure. Desmoplastic
mesothelioma affects males twice as frequently as females, and usually presents after
age 40, though it has been observed in patients as young as 12 years of age.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing: Desmoplastic mesothelioma is frequently mistaken for pleural fibrosis upon examination.
Biopsy analysis is required to confirm the diagnosis.
Physical findings: Common symptoms include:
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Pain in the chest or abdomen;
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Lumps or swelling at cancer site; and
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ICD-9: 163 (pleural); 158 (peritoneal); 164.1 (pericardial)
ICD-10: C45.0 (pleural); C45.1 (peritoneal); C45.2 (pericardial)
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PROGRESSION
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Desmoplastic mesothelioma has usually metastasized by the time it is discovered. The
prognosis is extremely poor, with a median survival rate of about six months following
diagnosis.
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TREATMENT
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Because desmoplastic mesothelioma tends to be in an advanced stage at the time of
diagnosis, surgery is rarely an option. Treatment is palliative and supportive, and
includes chemotherapy and targeted radiation to shrink tumors. Draining fluid buildup
can increase comfort and ease of breathing.
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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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Imaging reports such as CT scan or MRI scan;
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Pathology/biopsy reports.
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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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13.15 A
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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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