ANAPLASTIC ADRENAL CANCER - ADULT WITH DISTANT METASTASES OR INOPERABLE, UNRESECTABLE OR RECURRENT

ALTERNATE NAMES

DESCRIPTION

Anaplastic Adrenal Cancer is a sub-type of adrenal cancer, which shows virtually no cellular differentiation. It is not associated with overproduction of hormones as is seen in other types of adrenal carcinomas. Abdominal pain is a presenting symptom.

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

Diagnostic testing: Anaplastic Adrenal Cancer is diagnosed by CT or MRI scans. An adrenal gland biopsy is definitive.

Physical findings: Individuals with Anaplastic Adrenal Cancer generally present with:

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  Fever;

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  Weight loss;

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  Abdominal pain and tenderness;

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  Back pain;

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  Abdominal pain, fullness, and tenderness; and

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  An abdominal mass that is hard and non-movable.

ICD-9: 194.0

PROGRESSION

Median survival for anaplastic adrenal cancer is 5 months as compared with a median survival of 40 months for differentiated adrenal cancers.

TREATMENT

Radical surgical excision is the treatment for individuals with localized malignancies and remains the only method by which long-term disease-free survival may be achieved.

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 studies of CT scan or MRI will suggest a diagnosis; and

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  An adrenal gland biopsy is definitive.

“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:

DETERMINATION

LISTINGS

REMARKS

Meets

13.21

Anaplastic carcinoma of the adrenal gland is evaluated under 13.21 A if inoperable, unresectable, or recurrent. Anaplastic cancer of the adrenal glands with metastases is evaluated under 13.21 B.

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