Program Operations Manual System (POMS)
TN 16 (03-18)
DI 23022.300 Small Cell Cancer of the Large Intestine
COMPASSIONATE ALLOWANCE INFORMATION
SMALL CELL CANCER OF THE LARGE INTESTINE
Small Cell Cancer of the Large Intestine is an aggressive (fast-growing) cancer that forms in tissues of the intestine and can spread to other parts of the body. The cancer cells look small and oval-shaped when looked at under a microscope. Small cell carcinoma of the large intestine represents .2% to .8% of all colorectal malignancies. General symptoms may include: change in bowel habits, abdominal pain and weight loss.
Cancer of the Colon, Colorectal Small Cell Cancer, Small Cell Carcinoma of the Large Intestine
DIAGNOSTIC TESTING AND CODING
The diagnosis of colorectal small cell carcinoma is confirmed by pathology and the use of immunohistochemistry. Specific staining for CD56, pancytokeratin, LMWK, CK 7 and 19 are usually positive in small cell malignancies. Early diagnosis depends on routine screening. Occult blood study, sigmoidoscopy, colonoscopy, CT scan, endoscopy are used.
Treatment for colorectal small cell carcinoma is the use of combined chemotherapy and radiotherapy as is used in small cell carcinoma of the lung.
Survival rates are poor, usually less than 2 years.
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation: The diagnosis of small cell carcinoma of the large intestine is a pathologic diagnosis which would be confirmed by a pathology report of colonoscopy specimen.
Suggested Listings for Evaluation:
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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.