TN 8 (11-12)
DI 23022.985 Sinonasal Cancer
COMPASSIONATE ALLOWANCE INFORMATION
Sinonasal Malignancy; Sinonasal Undifferentiated Carcinoma; SNUC; Highly Aggressive Undifferentiated Carcinoma of the Nasal Cavity and Paranasal Sinuses
Sinonasal Cancer is a rare aggressive cancer of the nasal cavity or the paranasal sinuses. This cancer is often confused with other poorly differentiated carcinomas that begin in the sinonasal tract. These tumors mimic signs of sinusitis and have symptoms of nasal discharge (bloody or runny nose), nasal obstruction, and difficulty breathing through the nasal cavity, pressure in the mid-face, double vision, bulging eyes, and chronic infections.
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING
Diagnostic testing: Immunohistochemistry of biopsy; MRI or CT scans; PET scan; electron microscopy; and molecular biologic studies are used to diagnosis SNUC.
Physical findings: Physical findings may show a mass on the nasal cavity, ophthalmologic examination with eye papilledema (swelling of the optic disc) and proptosis (forward displacement of the eye), and diplopia (double vision).
ICD-9: 160.0 – 160.9
ONSET AND PROGRESSION
People with sinonasal malignancy usually present with advanced stage tumors following a rapid onset of symptoms. The prognosis of SNUC is poor once the cancer invades the skull and brain. Survival after treatment with chemotherapy and radiation is generally less than one year.
By the time this type of cancer is diagnosed, the tumor is usually clinically advanced and surgically unresectable. Treatment for sinonasal cancers involves multimodal therapy including surgical resection, and adjuvant therapy (i.e. chemotherapy, and radiation).
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for evaluation:
Suggested Listings for Evaluation:
13.02 A, B,C,D or E
Listing level severity must be documented.
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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.