| PRIMARY
PERITONEAL CANCER |
|
ALTERNATE NAMES
|
Primary Peritoneal Carcinoma; Primary Peritoneal Neoplasm; Primary Peritoneal Tumor;
Primary Peritoneal Sarcoma; Serous Surface Papillary Carcinoma; Serous Surface Papillary
Cancer; Serous Surface Papillary Sarcoma; Serous Surface Papillary Tumor; Serous Surface
Papillary Neoplasm; Extra Ovarian Serous Carcinoma; Extra Ovarian Serous Cancer; Extra
Ovarian Serous Neoplasm; Extra Ovarian Serous Tumor; Extra Ovarian Serous Sarcoma;
Primary Serous Papillary Carcinoma; Primary Serous Papillary Cancer; Primary Serous
Papillary Sarcoma; Primary Serous Papillary Tumor; Primary Serous Papillary Neoplasm
|
|
DESCRIPTION
|
Primary peritoneal cancer (PPC) is cancer that originates in the peritoneum, which is a moist sheet of tissue that
lines the abdominal cavity and the surface of the abdominal organs. The peritoneum
protects the organs and allows them to move smoothly within the abdomen. The cells
of the peritoneum develop from the same type of cells, which form the ovaries, so
PPC shares characteristics with ovarian cancer, and though rare PPC can occur in men.
The exact cause of PPC is not known, but may be associated with the gene BRCA1/2 (also
seen in ovarian cancer).
|
|
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
|
Diagnostic testing: The diagnosis of primary peritoneal cancer is made by:
-
•
History and physical exam;
-
-
-
-
•
Computerized Tomography (CT/CAT) scan;
-
•
Positron Emission Tomography (PET) scan;
-
•
Magnetic Resonance Imaging (MRI);
-
-
Physical findings: The signs and symptoms of primary peritoneal cancer may include:
-
•
Pain, swelling, or a feeling of pressure in the abdomen or pelvis;
-
•
Vaginal bleeding that is heavy or irregular, especially after menopause;
-
•
Vaginal discharge that is clear, white, or colored with blood;
-
•
Lump in the pelvic area; and
-
•
Gastrointestinal problems such as gas, bloating, or constipation
ICD-9: 158.8
ICD-10: Q91.7
|
| PROGRESSION
|
The prognosis for individuals with primary peritoneal cancer is often poor. Median
life expectancy is 1-2 years, with a range of 4 months to >5 years, the 5-year survival
rate is about 26%.
|
|
TREATMENT
|
The presentation of PPC may be in the advanced stages at initial diagnosis, making
curative treatment very difficult. Treatment may include surgery, radiation, and/or
chemotherapy. The treatment of primary peritoneal cancer depends on the stage/grade
of cancer; whether the patient has extra fluid in the abdomen that causes swelling;
whether the cancer is unresectable, metastatic, or recurrent; changes in the BRACA1
or BRACA2 genes; and the patient’s age and general health.
|
|
SUGGESTED PROGRAMMATIC ASSESSMENT*
|
Suggested MER for
Evaluation:
-
•
Clinical history and examination that describes the diagnostic features of the impairment;
-
•
Pathology/biopsy report of the cancer; and
-
•
Imaging reports such as CT scan, MRI scan; PET scan, and Ultrasound
|
| Suggested Listings for
Evaluation: |
| DETERMINATION |
LISTING
|
REMARKS
|
| Meets |
|
|
| Equals |
13.23 E
|
Primary peritoneal cancer, by definition equals 13.23E 1 a – extension to peritoneal
surfaces.
|
| * 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.
|