| ICD-9-CM: |
| 210 - | Neoplasm, Lip, Oral Cavity, and Pharynx, Benign |
| 210.2 - | Benign Neoplasm of Major Salivary Glands |
| 211 - | Neoplasm, Other Parts of Digestive System, Benign |
| 211.3 - | Polyp of Colon |
| 212 - | Neoplasm, Respiratory and Intrathoracic Organs, Benign |
| 213 - | Benign Neoplasm of Bone and Articular Cartilage |
| 217 - | Neoplasm, Benign Breast Nipple |
| 220 - | Benign Neoplasm of Ovary |
| 223 - | Benign Neoplasm of Kidney and Other Urinary Organs |
| 223.3 - | Benign Neoplasm of Kidney and Other Urinary Organs; Bladder |
| 225 - | Benign Neoplasm of Brain and Other Parts of Nervous System |
| 225.0 - | Benign Neoplasm of Brain and Other Parts of Nervous System; Brain |
| 225.1 - | Benign Neoplasm of Brain and Other Parts of Nervous System; Cranial Nerves |
| 225.2 - | Benign Neoplasm of Brain and Other Parts of Nervous System; Cerebral Meninges; Meninges NOS; Meningioma, Cerebral |
| 226 - | Benign Neoplasm of Thyroid Glands |
| 227 - | Benign Neoplasm of Other Endocrine Glands and Related Structures |
| 227.4 - | Benign Neoplasm of Other Endocrine Glands and Related Structures; Pineal Gland; Pineal Body |
| 229 - | Neoplasm, Other and Unspecified Sites, Benign |
| 229.8 - | Benign Neoplasm of Other and Unspecified Sites; Other Specified Sites; Intrathoracic NOS; Thoracic NOS |
| 229.9 - | Neoplasm, Benign; Site Unspecified |
| A tumor or neoplasm is an abnormal mass of tissue that forms when cells in a specific area reproduce at an increased rate. The cells are derived from normal cells, but undergo changes that make them unresponsive to the normal controls that help limit growth. These cells continue to grow faster than the surrounding tissue, resulting in an abnormal growth or tumor. Benign tumors can develop in almost any body organ and are found in the kidneys, liver, lungs, heart, brain, uterus, testicles, and on the skin. They are usually small (less than 1 cm in diameter) and are firm. They are often discovered incidentally when another condition is being investigated. Many are found during exploratory surgery (laparotomy), or during an autopsy.
The two basic types of tumors, benign tumors and cancerous (malignant) tumors, are distinguished by their cell types, growth patterns, and effects on the body. Benign tumors grow as well-defined masses that push normal cells out of the way rather than invade surrounding tissue; they are generally localized (restricted to a limited area). However, the cells in malignant tumors tend to invade surrounding tissue, and also migrate to other locations in the body (metastasize). Unlike malignant tumor cells, the cells in benign tumors do not metastasize or invade the vascular or lymph systems, although they can grow in groups and interfere with normally functioning tissue if they grow large enough to press on nearby structures. Benign tumors may block a vessel, impinge on a nerve, or grow in a vital area of the brain where they may compress neurovascular structures, causing other clinical problems. (See also lipoma and meningioma).
A benign tumor may form a capsule of connective tissue around itself that separates the tumor from adjacent normal cells. Growth of a benign tumor is usually slow; a tumor may not increase in size for months or years. Symptoms may not appear until the tumor grows to the point at which it presses on or disturbs nerve tracts, blood vessels, or other organs. Compression of other structures can be particularly dangerous in confined spaces such as inside the skull, the heart, or the lungs. Rarely, benign tumors can become malignant.Risk: It is unclear what causes the development of benign tumors. Many factors, such as environmental toxins, genetic influences, diet, emotional stress, trauma or local injury, and inflammation are thought to be possible causes. In some cases, particularly if hormone receptors are present on the multiplying cells, sex may be a factor in the development of certain types of benign tumors. Women are subject to the development of the hormone-related uterine tumors called fibroids; these occur more often in black women. Most benign tumors occur with equal frequency in both sexes and can develop in almost any region of the body. Incidence and Prevalence: Benign tumors represent about 80% of all tumors found in the heart, and about 20% are malignant, a ratio that approximately parallels tumor occurrence in other body organ systems (Bakeen 647). |
Source: Medical Disability Advisor
| History: Symptoms depend on the tissue of origin, and the size and location of the growth. Individuals may report noticing a lump or skin change. They may complain of nausea, a sense of fullness, or weight loss if an abdominal tumor is pressing on the stomach or nearby structures. Tumors can cause pain or nervous system disorders such as dizziness, unsteadiness, vision problems, weakness, or headaches if they compress or disturb nerve tracts or blood vessels. Physical exam: Physical findings may vary according to the site and size of the tumor. Examination may reveal a lump or skin change when the tumor is located in the soft tissue such as the breast, abdomen, muscle, or skin. However, if the tumor is small and located in the deep structures, such as the lungs, brain, or other organs, no physical abnormalities may be found. Tests: Diagnostic imaging may be used to visualize internal organs and to determine the location and size of a suspected tumor. X-ray, ultrasound, CT, or MRI may be used either solely or in combination, depending on the organ or tissue involved. A mammogram uses low-dose x-rays to identify changes in breast tissue. Direct inspection of certain internal organs may require the use of an endoscope, a small, lighted tube that is passed into the organ or cavity being examined. This technique is most often used for examinations of the colon (colonoscopy), stomach and adjacent organs (gastroscopy), bladder (cystoscopy), and abdominal cavity (laparoscopy).
Diagnosis is usually confirmed by microscopic examination of tumor tissue cells that have been surgically removed (biopsy) and stained by appropriate techniques. Benign tumor (neoplasm) cells retain many of the same features as the tissue in which they were found, although they will be typically denser than normal tissue. |
Source: Medical Disability Advisor
| The treatment of choice is to surgically remove the tumor, preferably with endoscopic techniques rather than open surgery. The type of surgery performed is specific to the location of the tumor and the anatomic area affected by the tumor. About 78% of benign tumors can be completely resected, 17% reduced in size by removing part of the tumor, and 1% will receive biopsy and will require other types of treatment (Noble 1455-56.) If the tumor is located in an inaccessible area, radiation therapy can slow or destroy the production and development of abnormal cells. Some benign tumors, such as fatty tumors (lipomas) on the skin, produce no symptoms and do not need to be removed unless they are painful, cumbersome, or are pressing on a nerve or blood vessel. Meningiomas, which are benign central nervous system tumors, are also surgically removed unless they are either of a recurrent type or are in a location where complete resection is not possible. In these cases, the benign tumor is treated by either conventional external radiation therapy or more focused stereotactic radiosurgery technique. The combination of ultrasound and a probe that freezes the tumor (cryotherapy) may be used to retard tumor growth in certain organs such as the uterus.
Certain systemic treatments that inhibit cell growth are used in individuals whose health is compromised by other conditions and who are not candidates for surgery. |
Source: Medical Disability Advisor
| The outcome following surgical removal of a benign tumor is usually good if the tumor is located in an accessible area. Symptoms are usually relieved with the removal of the tumor. A benign tumor may be incurable if it has the potential to become malignant and begins to infiltrate surrounding tissue. If the tumor cannot be removed, radiation therapy can slow or destroy the production and development of abnormal cells. Morbidity and mortality are low when comparing benign tumors to malignant ones. For example, the survival of individuals with benign cardiac tumors is 322 months, compared to 9.6 months in those with malignant cardiac tumors (Bakeen 647). |
Source: Medical Disability Advisor
| Complications are determined by the site and extent of the disease. Benign tumors can obstruct passageways, press on nerve tracts and cause nervous system disorders, disrupt the function of a vital organ, cause mental and physical disabilities, and may result in death. Brain tumors may have serious complications because of pressure on normal brain tissue. A brain tumor on the lining of the brain (meningioma) may be incurable if it infiltrates brain tissue or is in a location where it cannot be surgically removed or treated with radiation. Hemorrhage, necrosis, and obstruction are other possible complications with benign tumors. |
Source: Medical Disability Advisor
| The location of the tumor and type of surgical treatment dictate any work restrictions or accommodations needed. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Was presence of a tumor determined with a physical exam and diagnostic tests (CT, ultrasound, MRI)?
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Was diagnosis of benign tumor confirmed with a biopsy?
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Were conditions with similar symptoms, such as malignancy, foreign body or abscess, ruled out?
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Was tumor interfering with normal function of adjacent organs or structures?
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Was it accessible for surgical removal or treatment with radiation?
Regarding treatment:
- Was the tumor surgically removed? Was surgeon able to remove all the abnormal tissue?
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If the tumor is inaccessible, has radiation therapy been tried?
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How effective has radiation therapy been in halting or slowing the growth of the tumor?
Regarding prognosis:
- Was the tumor successfully removed?
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If the surgeon was not able to remove all the tissue, what impact does the remaining tissue have on function?
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Did surgery impact or alter individual's functional capabilities?
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Has individual received appropriate follow-up care to monitor the status of the tumor?
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Has tumor stopped growing?
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Does individual have an underlying condition (underlying organ dysfunction, bleeding disorder or immune suppression) that may affect recovery?
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Source: Medical Disability Advisor
| Bakaeen, F. G. "Surgical Outcome in 85 Patients with Primary Cardiac Tumors." American Journal of Surgery 186 6 (2003): 647-647.Noble, J., and H. L. Greene, eds. Textbook of Primary Care Medicine. 3rd ed. St. Louis: Mosby-Year Book, Inc., 2001. |
Source: Medical Disability Advisor
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