Program Operations Manual System (POMS)
TN 1 (10-08)
DI 23022.090 Adrenal Cancer
COMPASSIONATE ALLOWANCE INFORMATION
Adrenal Cancer forms in the outer tissue layer of the adrenal gland. Adrenocortical Carcinoma is also called Cancer of the Adrenal Cortex. A tumor of the adrenal cortex may be functioning (producing excess hormones) or non-functioning (not producing hormones). Individuals with the hereditary diseases LiFraumeni Syndrome, Beckwith-Wiedemann Syndrome, and Carney Complex are at risk for Adrenal Cancer.
Adrenal Carcinoma, Adrenocortical Carcinoma, Adrenocortical Cancer, Cancer of the Adrenal Cortex, Carcinoma of the Adrenal Cortex
DIAGNOSTIC TESTING AND CODING
The following may be used to diagnose the disease: x-rays, MRI, CT scan, and laboratory tests including blood and urine analysis.
Treatment may include surgery, radiation, and/or chemotherapy. Treatment for inoperable or unresectable tumors can be utilized for palliation, but the prognosis is poor.
The 5-year survival rate for inoperable or unresectable tumors is less than 10%.
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation: A pathology report and an operative report are the preferred methods for documentation.
In the absence of these reports, the adjudicator may use a physician's opinion that indicates the cancer is inoperable or unresectable based on described objective findings.
“Inoperable” refers to a physician's opinion that surgery would not be beneficial based on a review of imaging studies, laboratory results, and physical examination findings. Unresectable cancer is established when the operative report indicates that the cancer is not completely removed or the pathology report notes that the surgical specimen has positive margins.
Suggested Listings for Evaluation:
Adrenal Cancer that is inoperable, unresectable, recurrent, or with metastases meets Listing 13.21.
* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.
Last Updated: 9/30/08
Office of Disability Programs