Program Operations Manual System (POMS)
TN 57 (08-23)
COMPASSIONATE ALLOWANCES INFORMATION
|
PRIMARY OMENTAL CANCER
|
ALTERNATE NAMES
|
Primary Omentum Cancer
|
DESCRIPTION
|
Primary Omental Cancer is an extremely rare cancer that begins in the omentum, a fold of the thin tissue
known as the peritoneum that surrounds the stomach and other organs in the abdomen.
The function of the omentum is not fully understood, but it extends to every organ
in the abdomen and drapes over areas of inflammation, acting as a bandage to promote
healing if there is an infection or other health problem.
Tumors that originate in the omentum are extremely rare; less than 100 cases have
been documented.
Types of primary omental cancer include:
-
•
Gastrointestinal stromal tumors (GIST),
-
•
Malignant Hemaniopericytoma, and
The cause of primary omental cancer is unknown. Adults older than 50 are more likely
to get primary omental cancer.
|
DIAGNOSTICTESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM
CODING
|
Diagnostic testing: Diagnosis of primary omental cancer can be made by:
-
•
Computed tomography (CT) scans;
-
•
Magnetic resonance imaging (MRI);
-
•
Positron emission tomography (PET); and
Physical findings: Many individuals with primary omental cancer do not experience symptoms. Others may
notice a new, solid mass in their abdomen. The mass may feel tender to the touch,
or it may be painless.
Individuals with primary omental cancer may also have:
-
•
Inability to eat a full meal (early satiety);
-
•
Swollen abdomen (abdominal distention); or
ICD-9: 158.8,199.1
ICD-10: C48.1, C80.1
|
PROGRESSION
|
Individuals with this condition have a median survival time of only 6 months.
|
TREATMENT
|
Because of the rarity of the condition, effective treatment processes are unknown.
Chemotherapy or radiotherapy may be effective.
Primary omental cancer is typically found at an advanced stage, but in some cases,
tumors can be resected. However, only 10-20% of individuals survive 2 years after
surgical removal.
|
SUGGESTEDPROGRAMMATIC ASSESSMENT*
|
Suggested MER for Evaluation:
-
•
Clinical history and physical examination that describes the diagnostic features of
the impairment including a description of the size and stage of tumors;
-
•
Results of imaging (CT scan, MRI, ultrasound); and
-
•
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.
|
Suggested Listings for Evaluation:
|
DETERMINATION
|
LISTING
|
REMARKS
|
Meets
|
13.04
|
Primary greater omentum sarcomas must be of listing level severity.
|
Equals
|
13.04
|
|
* 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.
|