CHONDROSARCOMA
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ALTERNATE NAMES
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Chondrosarcoma Grade III; Dedifferentiated Chondrosarcoma; Mesenchymal Chondrosarcoma
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DESCRIPTION
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Chondrosarcoma
is the second most common form of bone cancer that primarily affects people over 40
years old, although it sometimes affects younger adults, adolescents, and children.
It usually originates in the legs, arms, shoulder blades, ribs, pelvis, or pelvic
bones, but may be found in any bone and sometimes outside of the bones (e.g., adjacent
muscles). Chondrosarcoma
with multimodal therapy indicates that the response to treatment has been poor and requires a combination
of chemotherapy, surgery, and radiation therapy before or after surgery.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing: Diagnostic testing for chondrosarcoma includes x-rays, CT or MRI imaging to identify
the tumor. A biopsy confirms the diagnosis.
Physical
findings: Physical findings of chondrosarcoma vary, depending on the location and size of the
tumor. Individuals may experience:
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Pain; Swelling or a lump at the tumor site;
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ICD-9: 170
ICD-10: C79.51
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PROGRESSION
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Chondrosarcoma usually begins as a single tumor. Spread (metastases) to other parts
of the body is common if the disease progresses to grade III, dedifferentiated, or
mesenchymal chondrosarcoma. Inoperable, unresectable, and metastatic chondrosarcomas
have poor prognoses, with less than a third of patients surviving five years.
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TREATMENT
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Surgery is the main treatment. Doctors may also use adjuvant chemotherapy if the cancer
has spread. Recurrent chondrosarcoma may require surgery and radiation, and perhaps
ablation treatments (e.g., liquid nitrogen or heating probes) to remove residual tumor.
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SUGGESTED PROGRAMMATIC ASSESSMENT*
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Suggested MER for Evaluation:
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•
Report that specifies the type, extent, and site of the primary, recurrent, or metastatic
lesion;
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•
Biopsy or needle aspiration information found in operative notes, pathology reports,
summaries of hospitalization or other medical reports that include details of the
surgical and pathological findings;
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Clinical history and examination that describes the diagnostic features of the impairment;
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Treatment records including surgical procedures, and up-to-date progress notes.
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Suggested Listings for Evaluation:
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DETERMINATION
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LISTING
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REMARKS
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Meets
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13.11 D
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Chondrosarcoma in adults treated with multimodal therapy meets 13.11 D without regard
to effectiveness of treatment.
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113.03
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Pediatric chondrosarcoma meets listing 113.03. |
Equals
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* 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.
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