TN 20 (12-18)

DI 23022.340 Anaplastic Thyroid Cancer

COMPASSIONATE ALLOWANCE INFORMATION

ANAPLASTIC THYROID CANCER

ALTERNATE NAMES

Anaplastic Thyroid Carcinoma; Thyroid Cancer

DESCRIPTION

Cancer that forms in the thyroid gland (an organ at the base of the throat that makes hormones that help control heart rate, blood pressure, body temperature, and weight).

There are four main types of thyroid cancer based on how the cancer cells look under a microscope:

  • Papillary;

  • Follicular;

  • Medullary; and

  • Anaplastic (makes up for about 2% of all thyroid cancers).

It begins in the follicular cells of the thyroid. The cancer cells tend to grow and spread very quickly. Anaplastic thyroid cancer is very hard to control. Early Thyroid Cancer often does not have symptoms. As the cancer grows, symptoms may include:

  • A lump in the front of the neck;

  • Hoarseness or voice changes;

  • Swollen lymph nodes in the neck;

  • Trouble swallowing or breathing; and

  • Pain in the throat or neck that does not go away.

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

Diagnostic testing: Diagnostic testing should include a history and physical exam to detect growths or swelling in the lymph nodes; blood tests to detect abnormal levels of TSH; ultrasound to detect thyroid nodules that are too small to be felt; thyroid scan and biopsy. A biopsy is the only sure way to diagnose Thyroid Cancer.

Physical findings: Firm cervical masses are highly suggestive of regional lymph node metastasis. Vocal fold paralysis implies involvement of the recurrent laryngeal nerve.

ICD-9: 193.0

PROGRESSION

Anaplastic Thyroid Cancer makes up about 2% of all thyroid cancers. Median survival is usually 4-5 months from the time of diagnosis.

TREATMENT

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis. The choice of treatment depends on the type of thyroid cancer (papillary, follicular, medullary, or anaplastic), the size of the nodule, the age of the individual, and whether the cancer has spread. Cancer may be treated with surgery, thyroid hormone treatment, radioactive iodine therapy, external radiation therapy, or chemotherapy. Most individuals receive a combination of treatments.

SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation:
  • The diagnosis of Anaplastic Thyroid Cancer is based on the pathology report from a thyroid biopsy specimen.

Suggested Listings for Evaluation:
DETERMINATION

LISTING

REMARKS
Meets 13.09 A Anaplastic Thyroid Cancer currently meets the criteria in 13.09 A.
Equals
* Adjudicators may, at their discretion, use the Medical Evidence of Record or the listings suggested evaluating 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/0423022340
DI 23022.340 - Anaplastic Thyroid Cancer - 12/13/2018
Batch run: 12/13/2018
Rev:12/13/2018