ALTERNATE NAMES

Metastatic Endometrioid Adenocarcinoma; Metastatic Endometrioid Carcinoma; Metastatic Uterine Adenocarcinoma; Metastatic Uterine Cancer; Metastatic Endometrioid Cancer; Metastatic Uterine Carcinoma

DESCRIPTION

Metastatic Endometrial Adenocarcinoma is a disease in which malignant cancer cells form in the tissue of the endometrial lining of the uterus and spread (metastasize) to distant parts of the body and other organs including the cervix, vagina, ovaries, lymph nodes, urinary bladder, rectum, bones, and lungs.

There are four stages of endometrial adenocarcinoma.

Stage I: The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.

Stage II: The tumor has spread from the uterus to the cervical stroma but not to other parts of the body.

Stage III: The cancer has spread beyond the uterus, but it is still only in the pelvic area.

Stage IV: The cancer has metastasized to the rectum, bladder, and/or distant organs.

Endometrial cancer can recur (come back) after it has been treated. The cancer may come back in the uterus , the pelvis , in lymph nodes in the abdomen , or in other parts of the body.

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

Diagnostic testing: The diagnosis and staging of endometrial adenocarcinoma is made by:

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  Chest x-ray;

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  Computed tomography (CT) scan;

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  Dilation and curettage (D&C);

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  Endometrial biopsy;

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  Hysteroscopy;

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  Lymph node dissection;

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  Magnetic resonance imaging (MRI);

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  Pelvic exam;

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  Positron emission tomography (PET) scan;

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  Physical exam and health history; and

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  Transvaginal ultrasound exam.

Physical findings: The physical findings of endometrial adenocarcinoma may include:

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  Abnormal uterine bleeding;

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  Irregular menstrual bleeding, spotting, and bleeding between menstrual periods;

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  Abdominal or pelvic pain;

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  Bloating;

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  Feeling full quickly when eating; and

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  Changes in bowel or bladder habits.

ICD-9: 182.0

ICD-10: C54.1

PROGRESSION

Cancer of the endometrium is the most common gynecologic malignancy in the United States and accounts for 7% of all cancers in women. Most cases are diagnosed at an early stage and are amenable to treatment with surgery alone. However, women with pathological features predictive of a high rate of relapse and patients with extrauterine spread at diagnosis have a high rate of relapse despite adjuvant therapy. While several treatment modalities are now available to treat women who present with metastatic endometrial cancer, overall prognosis remains poor.

TREATMENT

There are five types of standard treatment for people with endometrial cancer. Surgery is the most common treatment. During surgery, the cervix and uterus are removed (total hysterectomy), as well as both ovaries and fallopian tubes (salpingo-oophorectomy). Lymph nodes and other tissue may be removed and tested to find out if they contain cancer. Staging of the cancer occurs after surgery. The other treatment modalities are:

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  Radiation therapy;

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  Chemotherapy;

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  Hormone therapy; and

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  Targeted therapy.

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, MRI scan or PET scan;

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  Ultrasound reports; and

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  Biopsy or needle aspiration information found in operative notes, pathology reports, summaries of hospitalization or other medical reports that include details of the surgical and pathological findings.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets

13.23 A 1

13.23 A 2

Listing level severity must be documented. Stage IV disease generally indicates spread beyond the regional lymph nodes.

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