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

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: There is no standard or routine screening test for small-cell cancer of the ovary. Pelvic exam or 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:

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  Persistent bloating or increased abdominal size;

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  Pelvic or abdominal pain;

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  Difficulty eating;

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  Urinary symptoms;

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  Fatigue;

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  Indigestion;

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  Back pain;

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  Constipation; and

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  Menstrual irregularities.

ICD-9: 789.51; 795.82

ICD-10: R97.1

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 individuals with stage Ia disease have disease-free follow-up periods and almost all individuals with higher stage tumors die of disease, usually within two years.

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, individuals with high stage tumors have survived over four years after intensive chemotherapy, radiation therapy, or both.

Suggested MER for Evaluation:

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  A pathology report of a biopsy specimen from the ovary showing small-cell cancer. There is no substitute for pathology.

Suggested Listings for Evaluation:

Small-cell cancer of the ovary meets the criteria in listing 13.23F with a diagnosis supported by biopsy.