SMALL INTESTINE CANCER - WITH DISTANT METASTASES OR INOPERABLE OR RECURRENT

ALTERNATE NAMES

Small Intestine Adenocarcinoma; Small Intestine Carcinoid; Small Intestine Carcinoma; Small Intestine Gastrointestinal Stromal Tumor; Small Intestine Sarcoma

DESCRIPTION

Small intestine cancer forms in tissues of the small intestine. The most common type is adenocarcinoma. Most of these tumors occur in the part of the small intestine near the stomach. They may grow and block the intestine.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING

Diagnostic testing: The following may be used to diagnose the disease:

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  Physical exam and history;

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  Laboratory tests;

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  X-rays;

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  Barium enema;

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  Fecal occult blood test (FOBT);

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  Endoscopy;

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  Biopsy;

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  Computed tomography (CT) scan; and/or

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  Surgery.

Physical findings: Physical findings for small intestine cancer may include:

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  Blood in the stool (feces);

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  Dark/black feces;

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  Diarrhea;

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  A lump in the abdomen;

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  Pain or cramps in the abdomen;

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  Unexplained weight loss; and

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  Episodes of abdominal pain that may be accompanied by severe nausea or vomiting.

ICD-9: 152

ICD-10: C78.4

PROGRESSION

The overall 5-year survival rate for resectable adenocarcinoma is only 20%.

TREATMENT

Treatment may include surgery, radiation, biologic therapy, and/or chemotherapy.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

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  A pathology report;

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  An operative report; or

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  A physician's opinion that indicates the cancer is inoperable or unresectable based on described objective findings.
  
  

“Inoperable” refers to a physician's opinion that surgery would not be beneficial based on a review of imaging studies, laboratory results, and physical examination findings.

“Unresectable” cancer is established when the operative report indicates that the cancer is not completely removed or the pathology report notes that the surgical specimen has positive margins.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets

13.17

Small intestine cancer that is inoperable, unresectable, recurrent, or with distant metastases meets the criteria in listing 13.17.

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