TN 40 (10-20)

DI 23022.298 Secondary Adenocarcinoma of the Brain

COMPASSIONATE ALLOWANCE INFORMATION

SECONDARY ADENOCARCINOMA OF THE BRAIN

ALTERNATE NAMES

Adenocarcinoma Brain Metastasis; Brain Adenocarcinoma; Metastatic Adenocarcinoma of the Brain

DESCRIPTION

Secondary Adenocarcinoma of the Brain is a brain lesion caused by the spread of cancerous cells from a malignant tumor in another organ. Adenocarcinomas usually metastasize to the brain from primary tumors in the lung, though metastases originating in the breast or gastrointestinal organs have been observed.

Adenocarcinoma is a type of cancer that begins in glandular (secretory) cells. Glandular cells are found in tissue that lines certain internal organs that make and release substances in the body.

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

Diagnostic testing: The diagnosis is established by:

  • History and physical examination;

  • Brain imaging (CT or MRI scans);

  • Lumbar puncture;

  • Neurological testing; or

  • Blood tests

Physical findings: Common symptoms include:

  • Headaches;

  • Nausea and vomiting;

  • Seizures;

  • Cognitive decline;

  • Slurred or confused speech;

  • Impaired vision;

  • Numbness or weakness on one side of the body; and

  • Muscle weakness.

ICD-9: 198.3

ICD-10: C79.31

PROGRESSION

The prognosis for individuals with secondary adenocarcinoma of the brain is generally poor. Long-term survival is very rare but has been known to occur with aggressive treatment and therapy.

TREATMENT

Approach to treatment varies based on the site and aggressiveness of the primary tumor, but typically involves a combination of surgery, radiation, and chemotherapy.

Initial response to treatment tends to be favorable, but relapse within one year is common. Neurological impairment is a frequent side effect of treatment.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

  • Clinical history and examination that describes the diagnostic features of the impairment;

  • Imaging reports such as CT scan or MRI scan;

  • Operative reports; and

  • Pathology/biopsy reports.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets

13.08

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.09 B

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.09 C

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.10 C

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.
13.12 Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.14 A

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.15 B

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.16 A & B 2

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.17 B

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.18 C

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.21 B

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.22 D

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.23 A 2, B 3, C 2, & E 1 b

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

13.24 B

Adenocarcinoma in the brain may meet this listing as a distant metastasis of a primary cancer.

Equals

* Adjudicators may, at their discretion, use the Medical Evidence of Record or the listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022298
DI 23022.298 - Secondary Adenocarcinoma of the Brain - 10/05/2020
Batch run: 10/05/2020
Rev:10/05/2020