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Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Tumor, Benign


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Medical Codes

ICD-9-CM:
210.0 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Lip; Frenulum labii; Lip (Inner Aspect) (Mucosa) (Vermilion Border)
210.1 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Tongue; Lingual Tonsil
210.2 - Benign Neoplasm of Major Salivary Glands
210.3 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Floor of Mouth
210.4 - Other and Unspecified Parts of Mouth; Gingiva; Gum (Upper) (Lower); Labial Commissure; Oral Mucosa; Palate (Hard) (Soft); Uvula
210.5 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Tonsil; Tonsil (Faucial) (Palatine)
210.6 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Other Parts of Oropharynx; Branchial Cleft or Vestiges; Epiglottis, Anterior Aspect; Fossa; Pillars; Vallecula
210.7 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Nasopharynx; Adenoid Tissue; Lymphadenoid Tissue; Pharyngeal Tonsil; Posterior Nasal Septum
210.8 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Hypopharynx; Arytenoid Fold; Laryngopharynx; Postcricoid Region; Pyriform Fossa
210.9 - Benign Neoplasm of Lip, Oral Cavity, and Pharynx; Pharynx, Unspecified
211.0 - Benign Neoplasm of Other Parts of Digestive System; Esophagus
211.1 - Benign Neoplasm of Other Parts of Digestive System; Stomach; Body of Stomach; Cardia of Stomach; Fundus of Stomach; Cardiac Orifice; Pylorus
211.2 - Benign Neoplasm of Other Parts of Digestive System; Duodenum, Jejunum, and Ileum
211.3 - Polyp of Colon
211.4 - Benign Neoplasm of Other Parts of Digestive System; Rectum and Anal Canal; Anal Canal or Sphincter; Rectosigmoid Junction
211.5 - Benign Neoplasm of Other Parts of Digestive System; Liver and Biliary Passages; Ampulla of Vater; Common Bile Duct; Cystic Duct; Gallbladder; Hepatic Duct; Sphincter of Oddi
211.6 - Benign Neoplasm of Other Parts of Digestive System; Pancreas, except Islets of Langerhans
211.7 - Benign Neoplasm of Other Parts of Digestive System; Islets of Langerhans; Islet Cell Tumor; Use Additional Code to Identify Any Functional Activity
211.8 - Benign Neoplasm of Other Parts of Digestive System; Retroperitoneum and Peritoneum; Mesentery; Mesocolon; Omentum; Retroperitoneal Tissue
211.9 - Benign Neoplasm of Other Parts of Digestive System; Other and Unspecified Site; Alimentary Tract NOS; Digestive System NOS; Gastrointestinal Tract NOS; Intestinal Tract NOS; Intestine NOS; Spleen, Not Elsewhere Classified
212.0 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Nasal Cavities, Middle Ear, and Accessory Sinuses; Cartilage of Nose; Eustachian Tube; Nares; Septum of Nose; Ethmoidal; Frontal; Maxillary; Sphenoidal
212.1 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Larynx; Arytenoid; Cricoid; Cuneiform; Thyroid; Glottis; Vocal Cords (False) (True)
212.2 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Trachea
212.4 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Pleura
212.5 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Mediastinum
212.6 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Thymus
212.7 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Heart
212.8 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Other specified sites
212.9 - Neoplasm, Respiratory and Intrathoracic Organs, Benign, Site unspecified
213.0 - Neoplasm, Bones of Skull and Face, Benign
213.1 - Neoplasm, Lower Jaw Bone, Benign
213.2 - Neoplasm, Vertebral Column, Excluding Sacrum and Coccyx, Benign
213.3 - Neoplasm, Ribs, Sternum, and Clavicle, Benign
213.4 - Neoplasm, Scapula and Long Bones of Upper Limb, Benign
213.5 - Neoplasm, Short Bones of Upper Limb, Benign
213.6 - Neoplasm, Pelvic Bones, Sacrum, and Coccyx, Benign
213.7 - Neoplasm, Long Bones of Lower Limb, Benign
213.8 - Neoplasm, Short Bones of Lower Limb, Benign
213.9 - Neoplasm, Bone and Articular Cartilage, Benign, Site Unspecified
217 - Neoplasm, Benign Breast Nipple
220 - Benign Neoplasm of Ovary
223.0 - Benign Neoplasm of Kidney and Other Urinary Organs; Kidney, except Pelvis
223.1 - Benign Neoplasm of Kidney and Other Urinary Organs; Renal Pelvis
223.2 - Benign Neoplasm of Kidney and Other Urinary Organs; Ureter
223.3 - Benign Neoplasm of Kidney and Other Urinary Organs; Bladder
223.89 - Benign Neoplasm of Kidney and Other Urinary Organs; Specified Sites of Urinary Organs, Other; Other
223.9 - Benign Neoplasm of Kidney and Other Urinary Organs; Urinary Organ, Site Unspecified; Urinary System NOS
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
225.4 - Benign Neoplasm of Brain and Other Parts of Nervous System; Spinal Meninges; Spinal Meningioma
225.8 - Benign Neoplasm of Brain and Other Parts of Nervous System; Other Specified Sites of Nervous System
225.9 - Benign Neoplasm of Brain and Other Parts of Nervous System; Nervous System, Part Unspecified; Nervous System (Central), NOS
226 - Benign Neoplasm of Thyroid Glands
227.0 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Adrenal Gland; Suprarenal Gland
227.1 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Parathyroid Gland
227.3 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Pituitary Gland and Craniopharyngeal Duct; Craniobuccal Pouch; Hypophysis; Rathkes Pouch; Sella Turcica
227.4 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Pineal Gland; Pineal Body
227.5 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Carotid Body
227.6 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Aortic Body and Other Paraganglia; Coccygeal Body; Glomus Jugulare; Para-aortic Body
227.8 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Other
227.9 - Benign Neoplasm of Other Endocrine Glands and Related Structures; Endocrine Gland, Site Unspecified
229.0 - Benign Neoplasm of Other and Unspecified Sites; Lymph Nodes
229.8 - Benign Neoplasm of Other and Unspecified Sites; Other Specified Sites; Intrathoracic NOS; Thoracic NOS
229.9 - Neoplasm, Benign; Site Unspecified

Related Terms

  • Benign Lesion
  • Benign Mass
  • Benign Neoplasm
  • Non-cancerous Tumor

Overview

A benign tumor or neoplasm is a non-cancerous (non-malignant) abnormal mass of tissue that forms when cells in a localized area reproduce at an increased rate. The cells are derived from normal cells, but undergo changes that make them unresponsive to the biologic normal controls that limit growth. These cells continue to grow faster than the surrounding tissue, resulting in a tumor. Benign tumors can develop in almost any body organ and are found in the kidneys, liver, lungs, heart, brain, bone, uterus, testicles, ears, salivary glands, and on the skin. They usually are small (less than 1 cm in diameter) and are firm. Benign tumors often are 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 invading surrounding tissue; they tend to be restricted to a limited area (localized). Cells in malignant tumors tend to invade surrounding tissue and also to 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 ways that interfere with normally functioning tissue if they become large enough to press on nearby structures. Benign tumors may block a blood vessel, impinge on a nerve, or grow in a vital area of the brain where they may compress neurovascular structures, thus causing other clinical problems. (See also lipoma, meningioma, and neurofibroma).

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 nerves, blood vessels, or other organs. Compression of other structures can be particularly dangerous in confined spaces such as inside the skull, heart, or lungs. Rarely, benign tumors can become malignant.

Incidence and Prevalence: Since many benign tumors are asymptomatic, incidence is difficult to determine. Benign tumors represent about 2% to 5% of all tumors found in the lungs, and up to 50% can later become malignant (Gould).

Source: Medical Disability Advisor



Causation and Known Risk Factors

It is unclear what causes the development of benign tumors. Many factors, including environmental toxins, genetic influences, diet, emotional stress, local trauma or injury, and inflammation are thought to be possible causes, either singly or in combination. In some cases, particularly if hormone receptors are present on the multiplying cells, gender may be a factor in the development of certain types of benign tumors (e.g., women are subject to the development of hormone-related uterine tumors called fibroids). Nevertheless, most benign tumors occur with equal frequency in both sexes and can develop in almost any region of the body.

Source: Medical Disability Advisor



Diagnosis

History: Symptoms depend on the cell type of origin, size and location of the growth, and the organ system involved. Individuals may report noticing a lump or skin change. If an abdominal tumor is pressing on the stomach or nearby structures, individuals may complain of nausea, a sense of fullness, or weight loss. When tumors compress or disturb nerves, they can cause pain or disorders such as dizziness, unsteadiness, vision problems, weakness, or headaches.

Physical exam: Physical findings 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 is located in a deep structure 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, high resolution computed tomography (CT), or magnetic resonance imaging (MRI) may be used either alone or in combination to examine tissue in more detail, depending on location involved. Direct inspection of certain internal organs may require the use of an endoscope, a small, lighted fiberoptic instrument that is passed into the organ or cavity being examined. This minimally invasive technique is used most often for examinations of abdominal or pelvic organs such as the colon (colonoscopy), stomach and adjacent organs of the gastrointestinal tract (gastroscopy), bladder (cystoscopy), and abdominal cavity (laparoscopy). Thoracotomy or thorascopy may be used to examine the lungs.

Differentiating between benign and malignant tumors requires an evaluation of tumor cells by a pathologist (histopathologic examination). Diagnosis usually is confirmed by microscopic examination of tumor tissue cells that have been removed surgically (biopsy) or aspirated by needle biopsy and stained by appropriate techniques. For example, up to 50% of benign lesions in the lung are identified by biopsy and cell differentiation study (Gould). Differentiation refers to the extent to which cells resemble the normal cells of origin in terms of size, morphology, and function. Differentiation can range from well-differentiated, as in benign lesions, to moderately well differentiated, which can be either benign or malignant, to cells showing much less differentiation (anaplastic), or undifferentiated; anaplastic and undifferentiated lesions are characteristically malignant with many changes in size, shape, and degree of proliferation. Benign tumor cells retain many of the same features as the cells of the tissue from which they arose, although the tumor tissue typically will be denser than normal tissue, and cell proliferation will be less than in malignant tumors.

Distinguishing between a benign and malignant lesion also depends on the presence of metaplasia or dysplasia in the tissue. Metaplasia describes a condition of tissue damage, repair, and regeneration of cells; however, the replacement cells are not of the same type as the original tissue. The cells in the tumor are abnormal and have differentiated into tissue of another kind. Dysplasia refers to disordered growth that includes loss of uniformity among cells and changes in their composition that are typical of malignant neoplasms.

Source: Medical Disability Advisor



Treatment

The treatment of choice usually is to surgically remove (resect) the tumor, preferably with endoscopic techniques rather than open surgery. Indications for surgery include the presence of symptoms, radiographic evidence of tumor growth, or a large tumor that is compromising function of a vital structure. The type of surgery performed is specific to the location of the tumor and the anatomic area affected by the tumor. Most benign tumors can be completely resected, reduced in size by removing part of the tumor, or destroyed using other types of treatment. If the tumor is located in an inaccessible area, radiation therapy can slow or destroy the production and development of abnormal cells. Meningiomas, which are benign central nervous system tumors, usually are 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 by a more focused stereotactic radiosurgery technique. In certain organs such as the uterus, the combination of ultrasound and a probe that freezes the tumor (cryotherapy) may be used to retard tumor growth. Certain systemic treatments, such as drug therapies that inhibit cell growth, are used to retard the growth of benign tumors in individuals whose health is compromised by other conditions and who are not candidates for surgery.

Some benign tumors, such as fatty tumors (lipomas) between the skin and underlying muscle, produce no symptoms and do not need to be removed unless they are painful, cumbersome, or are pressing on a nerve or blood vessel.

Source: Medical Disability Advisor



Prognosis

The outcome following surgical removal of a benign tumor usually is good if the tumor is located in an accessible area. Symptoms usually are relieved with the removal of the tumor. Some benign tumors have the potential to become malignant and can begin to infiltrate surrounding tissue. If a benign tumor cannot be removed, radiation therapy or cryotherapy often can slow or destroy the production and development of abnormal cells. Morbidity and mortality are low when comparing benign tumors to malignant ones.

Source: Medical Disability Advisor



Differential Diagnosis

  • Abscess
  • Cyst
  • Foreign bodies
  • Hemangioma
  • Malignant tumors

Source: Medical Disability Advisor



Specialists

  • Dermatologist
  • Endocrinologist
  • Family Physician
  • Gastroenterologist
  • General Surgeon
  • Gynecologist
  • Internal Medicine Physician
  • Neurologist
  • Pathologist
  • Radiologist
  • Urologist

Source: Medical Disability Advisor



Comorbid Conditions

Source: Medical Disability Advisor



Complications

The site of the tumor and extent of the disease determine complications. Benign tumors can obstruct passageways, press on nerves 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 such as neurological deficit 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 and tissue death (necrosis) are other possible complications with benign tumors.

Source: Medical Disability Advisor



Factors Influencing Duration

Duration depends on the type and location of the tumor, the type of treatment required, and the individual's response to treatment.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

The location of the tumor and type of surgical or other treatment dictate any work restrictions or accommodations needed. Individuals receiving radiologic therapy to reduce tumor size may require time off to receive and recover from treatments.

Source: Medical Disability Advisor



Failure to Recover

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 individual symptomatic?
  • Was presence of a tumor determined with a physical exam and diagnostic tests (CT, ultrasound, MRI)? Endoscopic examination such as laparoscopy, thorascopy, colonoscopy, or cystoscopy?
  • Was diagnosis of benign tumor confirmed with a biopsy?
  • Were conditions with similar symptoms, such as malignancy, foreign body or abscess, ruled out?
  • Was tumor interfering with normal function of adjacent organs or structures?
  • Was tumor accessible for surgical removal or treatment with radiation?

Regarding treatment:

  • Was the tumor surgically removed? Was surgeon able to remove all the abnormal tissue?
  • If the tumor is inaccessible, has radiation therapy been given?
  • How effective has radiation therapy been in halting or slowing the growth of the tumor?
  • Is cryotherapy a viable alternative treatment for this tumor?
  • Is individual a candidate for tumor-inhibiting drug therapy?

Regarding prognosis:

  • Was the tumor successfully removed?
  • If the surgeon was not able to remove all the tissue, what impact does the remaining tissue have on function?
  • Did surgery reduce or alter individual's functional capabilities?
  • Has individual received appropriate follow-up care to monitor the status of the tumor?
  • Has tumor stopped growing? Recurred?
  • Does individual have an underlying condition (underlying chronic illness, organ dysfunction, bleeding disorder or immune suppression) that may affect recovery?
  • Have complications of tumor growth or treatment developed? Are they being treated?

Source: Medical Disability Advisor



References

Cited

Gould, Michael, and Norman W. Rizk. "Benign Tumors." Murray & Nadel’s Textbook of Respiratory Medicine. Eds. Robert J. Mason, et al. 4th ed. Saunders Elsevier, 2005. MD Consult. Elsevier, Inc. 8 Sep. 2009 <http://mdconsult.com>.

General

Stricker, Thomas, and Vinay Kumar. "Characteristics of Benign and Malignant Neoplasms." Robbins and Cotran Pathologic Basis of Disease. Eds. Vinay Kumar, et al. 8th ed. Saunders Elsevier, 2009. MD Consult. Elsevier, Inc. 8 Sep. 2009 <http://mdconsult.com>.

Source: Medical Disability Advisor