TN 20 (12-18)

DI 23022.305 Small Cell Cancer of the Ovary

COMPASSIONATE ALLOWANCE INFORMATION

SMALL CELL (OAT CELL) CANCER OF THE OVARY

ALTERNATE NAMES

Cancer of the Ovary; Small Cell Carcinoma of the Ovary; SCCO

DESCRIPTION

Small Cell Cancer of the Ovary is an extremely rare type of ovarian cancer that is distinguished from other ovarian epithelial and ovarian germ cell tumors. It is divided into two types, the hypercalcemic and the pulmonary type, of which the latter is extremely rare. Small cell cancer of the ovary tends to occur in young women (under 40 years of age).

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

Diagnostic testing: There is no standard or routine screening test for small cell cancer of the ovary. Pelvic exam, transvaginal ultrasound may detect ovarian cancer. Biopsy is the primary method of diagnosis and staging of the disease.

Physical findings: Symptoms of small cell cancer of the ovary are often subtle. They may include:

  • Persistent bloating or increased abdominal size;

  • Pelvic or abdominal pain;

  • Difficulty eating;

  • Urinary symptoms;

  • Fatigue;

  • Indigestion;

  • Back pain;

  • Constipation; and

  • Menstrual irregularities.

ICD-9: 789.51, 795.82

PROGRESSION

Small Cell Cancer of the Ovary is a highly aggressive tumor. Metastatic tumor occurs mostly within the pelvis and abdomen, but hematogenous spread also occurs. Only one-third of patients with stage Ia disease have disease-free follow-up periods and almost all patients with higher stage tumors die of disease, usually within 2 years.

TREATMENT

The primary form of treatment for Small Cell Cancer of the Ovary is surgery with chemotherapy or radiotherapy, depending on the stage of the disease. Effective treatment of patients with high-stage tumors or recurrent disease has not been achieved; although rare, patients with high stage tumors have survived over 4 years after intensive chemotherapy, radiation therapy, or both.

SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation:
  • A pathology report of a biopsy specimen from the ovary showing small cell cancer. There is no substitute for pathology.

Suggested Listings for Evaluation:
DETERMINATION

LISTING

REMARKS
Meets 13.23 F Small Cell Cancer of the Ovary meets the criteria in 13.23 F with a diagnosis supported by biopsy.
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/0423022305
DI 23022.305 - Small Cell Cancer of the Ovary - 12/13/2018
Batch run: 12/13/2018
Rev:12/13/2018