TN 21 (12-18)

DI 23022.315 Small-Cell Cancer of the Female Genital Tract

COMPASSIONATE ALLOWANCE INFORMATION

SMALL-CELL CANCER OF THE FEMALE GENITAL TRACT

ALTERNATE NAMES Small-Cell Carcinoma of the Uterus; Small-Cell Carcinoma of the Vagina; Small-Cell Carcinoma of the Vulva; Small-Cell Carcinoma of the Endometrium; Small-Cell Carcinoma of the Fallopian Tube; Small-Cell Cancer of the Ovary; Small-Cell Cancer of the Cervix; Vaginal Small-Cell Carcinoma; Vaginal Small-Cell Cancer; Primary Vaginal Small-Cell Carcinoma; Poorly Differentiated Neuroendocrine Cancer of the Vaginal Tract

DESCRIPTION

Small-Cell Cancer (SCC) of the Female Genital Tract (FGT) occurs most frequently in the cervix, but can also occur in the endometrium, ovary, fallopian tube, vagina, and vulva. It is an extremely aggressive cancer with a biological behavior that is similar to small-cell cancer of the lung. Neuroendocrine tumors of the FGT, of which SCC FGT are a subset are rare cancers that account for less than 2% of gynecological cancers.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9 CODING

Diagnostic testing: CT Scan of FGT, brain, chest, abdomen, and pelvis; and bone marrow testing.

Physical findings: Individuals with SCC FGT may be asymptomatic but usually present with:

• Localized pain;

• Vaginal bleeding;

• Abdominal bloating or a mass; or

• Symptoms of metastasis disease to the liver, bone, lung, or regional lymph nodes.

ICD 9: 179.;180.1;180.8; 183.0; 183.2; 183.3; 183.5; 183.8; 183.9;184.4; 184.8; 184.9

TREATMENT

There is no standard treatment for SCC FGT. Treatment is symptom specific and generally consists of a combination of surgery; radiation; chemotherapy; and immunotherapy.

PROGRESSION

SCC of the uterus or cervix is a highly aggressive tumor that often metastasizes early and widely by both lymphatic and haematogenous routes and involves regional and distant lymph nodes, lung, bone and brain and liver. The disease-free interval is usually less than two years with an almost 70% rate of recurrence within 12 months of diagnosis. Long-term survival is possible for individuals with cancers that are clinically localized to the cervix but individuals with more advanced stage of the disease is poor with very few long-term survivors.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

• Clinical history and examination that describes the diagnostic features of the impairment; and

• Pathology report showing SCC FGT.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets

13.23 F

SCC FGT meets the criteria in listing 13.23 F upon confirmed diagnosis.

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.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022315
DI 23022.315 - Small-Cell Cancer of the Female Genital Tract - 12/28/2018
Batch run: 12/28/2018
Rev:12/28/2018