Program Operations Manual System (POMS)
TN 1 (10-08)
DI 23022.270 Peritoneal Mesothelioma
COMPASSIONATE ALLOWANCE INFORMATION
Peritoneal Mesothelioma is a rare cancer of the abdominal lining (1 per 1,000,000). It is usually associated with asbestos exposure and is regarded as universally fatal. Exposure to asbestos fibers can cause mesothelioma even years later. There is evidence that family members and others living with people exposed to asbestos have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever.
Malignant Mesothelioma of the Peritoneum
DIAGNOSTIC TESTING AND CODING
Diagnosing Peritoneal Mesothelioma is often difficult; because the symptoms are often associated with other conditions. Diagnostic testing includes a review of the patient's medical history and a complete physical examination, including x-rays of the abdomen. Diagnostic imaging by CT scan and MRI suggests a diagnosis, but definitive diagnosis is via tissue sampling by CT-directed biopsy or peritoneoscopy.
Standard treatment for all but localized mesothelioma is generally not curative. However, radical resection is associated with a better prognosis and should be attempted when possible. Chemotherapy can be administered systemically or directly into the abdomen and is helpful as palliative treatment.
Delayed diagnosis of mesothelioma worsens its prognosis. In general, the prognosis of mesothelioma is poor and most studies report median survival of less than a year.
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation: Biopsy.
Suggested Listings for Evaluation:
Peritoneal Mesothelioma equals this listing based on diagnosis confirmed by biopsy.
* 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