Program Operations Manual System (POMS)
   TN 82 (09-25)
   DI 23022.185 Glioblastoma Multiforme (Adult Brain Cancer)
   
   
   
   
      
         
            
            
            
         
         
            
            
               
               | COMPASSIONATE ALLOWANCES INFORMATION  | 
         
         
            
            
               
               | GLIOBLASTOMA
                        MULTIFORME
                        (ADULT BRAIN CANCER) | 
            
               
               | ALTERNATE NAMES  | Diffuse Midline Glioma; GBM; Giant Cell Glioblastoma; Glioblastoma; Glioblastoma Adult
                     Brain Tumor; Glioblastoma, IDH Mutant; Glioblastoma, IDH Wildtype; Glioblastoma, NOS;
                     Gliosarcoma; Gliosarcoma, IDH Wildtype; Grade IV Astrocytoma; H3K27M-Mutant
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               | DESCRIPTION | Glioblastoma
                        multiforme is a fast-growing type of central nervous system cancer that forms from glial (supportive)
                     tissue of the brain and spinal cord and has cells that look very different from normal
                     cells. It spreads aggressively throughout the brain tissue and is the most malignant
                     of the primary brain cancers. In consequence, these cancers are difficult to treat
                     and often recur after initial therapy. Glioblastoma multiforme most often occurs in
                     adults between the ages of 45 and 70 years and affects the brain more often than the
                     spinal cord.
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               | DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9–CM/ICD-10-CM CODING  | Diagnostic testing: Diagnosis is based on:
                   
                     
                        
                     
                        
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                              Neurological examination; and
                        
                      The only definitive test that can provide a diagnosis of glioblastoma is a biopsy
                     of the cancer. Testing to confirm diagnosis of glioblastoma includes neuroimaging
                     (computed tomography (CT) and magnetic resonance imaging (MRI)) to provide information
                     about the location, size, and shape of the cancer.
                   Physical findings: Individuals with this impairment may present with:
                   
                     
                        
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                              Slowly progressive neurologic deficits; 
                     
                        
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                              Increased intracranial pressure including headaches, nausea, and vomiting, and cognitive
                                 impairments;
                               
                     
                        
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                              Changes in mood and personality; and ICD-9: 191.9
                   ICD-10: C71.9
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               | PROGRESSION  | Glioblastoma multiforme is highly aggressive, infiltrating, and responds poorly to
                     all currently available treatments. The prognosis is grim, as most patients die within
                     two years and few survive longer than three years.
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               | TREATMENT  | Treatment of glioblastoma multiforme may include the following: surgery, radiation,
                     and/or chemotherapy.
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               | SUGGESTED PROGRAMMATIC ASSESSMENT* | 
            
               
               | Suggested Listings for Evaluation:  
                     
                        
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                              Pathology report of the cancer biopsy or surgical specimen is the critical information
                                 necessary for disability evaluation;
                              
                        
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                              Clinical history and examination that describes the diagnostic features of the impairment;
                        
                     
                        
                     
                        
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                              Results of neuroimaging (e.g. CT scan, MRI scan). | 
            
               
               | Suggested Listings for Evaluation: | 
            
               
               | DETERMINATION | LISTING | REMARKS | 
            
               
               | Meets | 13.13 A 1 |   | 
            
               
               | 113.13 A |   | 
            
               
               | 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.
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