Program Operations Manual System (POMS)
TN 31 (08-20)
DI 23022.945 Endometrial Stromal Sarcoma
COMPASSIONATE ALLOWANCES INFORMATION
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ENDOMETRIAL STROMAL SARCOMA
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ALTERNATE NAMES
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Endometrial Stromal Sarcoma Grade III/IV; High Grade Endometrial Stromal Sarcoma;
ESS; Undifferentiated Uterine Sarcoma; UUS
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DESCRIPTION
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Endometrial Stromal Sarcoma (ESS) is the rarest type of uterine cancer that accounts for less than 1% of cancers of
the female reproductive organs. These tumors tend to occur more often in premenopausal
women between 40-50 years of age. This is younger than the average for uterine cancer
in general (early 60s). African American women are two times more likely to get these
rare uterine cancers.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing:
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Examination of endometrial cells collected during a dilation and curettage (D&C) procedure;
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MRI or CT scans of the pelvis.
Physical findings:
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Vaginal bleeding and/or spotting in postmenopausal women;
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Abnormal uterine bleeding;
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Anemia caused by chronic loss of blood;
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Lower abdominal pain or pelvic cramping; or
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ICD-9:
182.0
ICD-10: C54.1
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PROGRESSION
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The prognosis for ESS is poor as it is a high grade malignancy that grows and metastasizes
quickly. By the time this sarcoma is diagnosed, it has often spread outside of the
uterus. Once treated, it also has a high propensity for recurrence.
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TREATMENT
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Most ESS are treated with complete surgical resection including total abdominal hysterectomy
(removal of the uterus) and bilateral salpingo-oophrorectomy (removal of the fallopian
tube and ovary), plus chemotherapy and radiation therapy.
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SUGGESTED PROGRAMMATIC
ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Pathology report of a biopsy specimen of the stroma of the endometrium; and
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Surgery reports and/or imaging that document spread of cancer.
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Suggested Listings for
Evaluation: |
DETERMINATION
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LISTING
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REMARKS
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Meets
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13.04 A or B
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Listing level severity must be documented.
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13.23 A
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Listing level severity must be documented. |
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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