Brain Cancer
Disease of the brain in which malignant cells or cancer cells arise in the brain tissue is called brain cancer. The brain functions such as muscle control, sensation, memory and other normal body functions are interfered by cancer tissue. Cancer tissue can be also called as Tumor. There are malignant tumors which are composed of cancerous cells and benign tumors which are composed of noncancerous cells. Primary brain tumors are cancer cells that develop from brain tissue. Metastatic or Secondary brain tumors are those that spread from other body sites to the brain. Cancer that develops in a body organ and spreads by direct extension though the blood or lymphatic system to other body organs are metastatic or secondary brain tumors.
Most common signs and symptoms of brain cancer are:
- Dizziness
- Seizures
- Headache and weakness
- Vomiting
- Blurry vision
- Hallucinations
CT scan, biopsy, MRI and other tests helps in detecting brain cancer.
All tumors of brain are not alike, even if they are from the same type of brain tissue. There are grades on the appearance of the cells of the tumor. There are four types of grades from benign to the aggressive:
- Grade I: This is benign tissue, they grow slowly and they look like normal cells. Eg: Acoustic neuroma.
- Grade II: This is malignant tissue. These look lesser like normal cells compared to Grade I.
- Grade III: This is malignant type and the appearance is very different from normal cells. This is an aggressive tumor.
- Grade IV: This is malignant type. This is the most abnormal one and grows fast.
The brain tumors are named according to the brain tissue type from where they develop. The severity of the disease is better understood by the grades and tumor name.
Type of brain cancers are as follows:
- Meningiomas
- Gliomas. These are further classified into:
- Astrocytomas
- Oligoendrogliomas
- Ependymomas
- Choroid plexus papillomas. These names are different types of cells that become cancer.
- Pituitary adenomas
- Vestibular schwannomas and
- Primitive neuroectodermal tumors or medulloblastomas.
Stages of brain cancer:
- They are staged according to the grade and cell type.
- The cancers which are staged according to cell type and grades are those that spread to other organs.
- Other stages of cancer are on the basis of location and spread. Also, called as TMN staging.
- The stages of cancer range from 0 to 4. Stage 4 indicates that the cancer has spread to the other organ. Stage 4 is the highest.
According to the National Cancer Institute (NCI) and the American Cancer Society, brain cancer occurs in about 22,800 new people in a year and about 15,000 deaths.
Brain cancer in ICD-10-CM requires the documentation of the anatomical location within the brain, like ICD-9-CM.
The following anatomical locations are listed within category C71 ? Malignant neoplasm of the brain:
- Malignant Neoplasm of cerebrum, except lobes and ventricles – C71.0
- Malignant Neoplasm of frontal lobe – C71.1
- Malignant Neoplasm of temporal lobe – C71.2
- Malignant Neoplasm of parietal lobe – C71.3
- Malignant Neoplasm of occipital lobe – C71.4
- Malignant Neoplasm of cerebral ventricle (new in ICD-10-CM) – C71.5
- Malignant Neoplasm of cerebellum – C71.6
- Malignant Neoplasm of brain stem – C71.7
- Malignant Neoplasm of overlapping sites – C71.8
- Malignant Neoplasm of, unspecified – C71.9
Cerebral ventricle is a new addition in ICD-10-CM.
Secondary (metastatic) brain cancer is coded as C79.31. There are three codes for benign brain tumors:
- Benign neoplasm of brain, supratentorial D33.0
- Benign neoplasm of brain, infratentorial D33.1
- Benign neoplasm of brain, unspecified D33.2
Other codes for brain tumors include:
- Neoplasm of uncertain behavior of brain, supratentorial – D43.0
- Neoplasm of uncertain behavior of brain, infratentorial – D43.1
- Neoplasm of uncertain behavior of brain, unspecified – D43.2
- Neoplasm of unspecified behavior of brain – D49.6
The specific code should be assigned by determining the histology as :
- Benign
- Malignant
- In-situ
- Uncertain behavior and the anatomical location.
- The neoplasm table has a category, subcategory or code.
- The tabular list has instructions for coding and guidelines. The alphabetic index does not have the neoplasm table but can be used to code by histology. It can be found after the alphabetic index and before the table of drugs.
Note: It is very important to read the ICD-10-CM guidelines, while going through a new coding system.