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Malignant Neoplasm of the Oral Cavity, Oropharynx and Hypopharynx B034

Document
Last amended 
6 July 2017
Current RMA Instruments
Reasonable Hypothesis
1 of 2013
Balance of Probabilities
2 of 2013
Changes from previous Instruments

SOP Bulletin 163

ICD Coding
  • ICD-9-CM Codes: 140.3,140.4,140.5,141,143,144,145,146,148
  • ICD-10-AM Codes: C00-C06, C09-C10, C12-C13
Brief description

This SOP covers cancers of mouth cavity (oral cavity), the back of the mouth cavity (oropharynx) and the area of the throat immediately below that (hypopharynx).

Confirming the diagnosis

Evidence on the histological type of tumour and the specific site of the tumour will be required, either from a biopsy or a surgical specimen.  There are a number of cancer types involving these sites that are excluded from this SOP, including minor salivary gland cancers, which occur in the oral cavity but which are covered by a separate SOP.  See excluded conditions list below.

The appropriate medical specialist is an Ear, Nose and Throat surgeon.

Sites covered by SOP
  • alveolar ridge
  • buccal (cheek) mucosa
  • floor of mouth
  • gingiva
  • gums
  • hard palate mucosa
  • hypopharynx
  • lingual tonsil coverings
  • lips (mucosa of inside only)
  • oropharynx
  • palatine or faucial tonsil coverings
  • post cricoid fossa
  • pyriform fossa
  • soft palate mucosa
  • tongue mucosa
  • tonsil fossa
  • vallecula
Conditions excluded from SOP
  • adenoid cystic carcinoma in the oral cavity (= minor salivary gland cancer)* - malignant neoplasm of the salivary gland SOP
  • malignant neoplasm of the larynx*
  • malignant neoplasm of the lip epithelium* - non-melanotic malignant neoplasm of the skin SOP
  • malignant neoplasm of the nasopharynx*
  • malignant neoplasm of the minor salivary glands* - malignant neoplasm of the salivary gland SOP
  • malignant neoplasm of the oesophagus*
  • malignant neoplasm of the salivary glands* (parotid, sublingual, submandibular)
  • Hodgkin’s lymphoma* of the oral cavity, oropharynx or hypopharynx
  • non-Hodgkin’s lymphoma* of the oral cavity, oropharynx or hypopharynx
  • soft tissue sarcoma* of the oral cavity, oropharynx or hypopharynx
  • carcinoid of the oral cavity, oropharynx or hypopharynx#
  • secondary/metastatic cancer/carcinoma involving the oral cavity or hypopharynx (code to primary cancer site)

* another SOP applies

# non-SOP condition

Clinical onset

These conditions may present with a range of symptoms, such as non-healing mouth ulcers, pain, bleeding and difficulty swallowing.  On confirmation of diagnosis it may be possible to back-date clinical onset based on when relevant symptoms first began.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management. Appropriate management generally involves surgery or radiotherapy +/- chemotherapy.  Effectiveness of treatment varies with the type and stage or disease.