Program Operations Manual System (POMS)
TN 10 (01-14)
DI 23022.221 Liposarcoma - Metastatic or Recurrent
COMPASSIONATE ALLOWANCE INFORMATION
Dedifferentiated Liposarcoma; Pleomorphic Liposarcoma; Inflammatory Liposarcoma; Spindle Cell Liposarcoma; Myxoid Liposarcoma
Liposarcoma is a tumor that arises from fat tissue. This tumor often occurs in the thigh, behind the knee, or in the abdomen, but it can be found in other parts of the body. Liposarcomas occur in tissue that is elastic and easily moved causing the tumors to exist a long time before symptoms become evident. Liposarcomas may start out as benign tumors, but later become malignant tumors and grow into surrounding tissues or organs. Liposarcoma that is metastatic or recurrent is considered an aggressive tumor because it often spreads to other parts of the body. The exact cause of liposarcoma is unknown but probably is related to genetic mutations.
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING
Diagnostic testing: X-ray or MRI of the affected areas; and histologic examination of tissue by needle or surgical biopsy.
Physical findings: Physical examination may reveal painless swelling or a mass on the body that tends to be large, firm, and near underlying structures; pain or soreness caused by compressed nerves or muscles; limping or difficulties using the legs, feet, arms or hands; and reduced range of motion in the affected areas.
ICD-9: 171.X Depends on the location of the tumor
ONSET AND PROGRESSION
Liposarcomas most often occur in people between the ages of 40 years of age to 60 years of age. It may also occur in children during the teenage years. The prognosis of liposarcoma varies and is based on the size, location, and recurrence of the tumors.
The treatment for liposarcoma depends on the type, size, and location of the tumor, recurrence, and spread (metastasis) of the tumor. A combination of surgery and radiation therapy is most often used.
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for evaluation:
Suggested Listings for Evaluation:
13.04A or B;
Regional or distant metastases meets 13.04A; recurrent disease meets 13.04B.
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* 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.