Malignant Neoplasm of the Ovary and Fallopian Tube B023

Current RMA Instruments

Changes from previous Instruments

ICD Coding

• ICD-10-AM Codes: C56, C57.0, D39.1

Brief description

Malignant neoplasm of the ovary and fallopian tube is a primary malignant tumour arising from the cells of the ovary or fallopian tube. Most are epithelial cancers (carcinomas), although malignant stromal and germ cell tumours also occur. The SOP also includes tumours of borderline malignant potential. 

Confirming the diagnosis

Diagnosis requires histological confirmation of a primary malignant neoplasm arising from the ovary or fallopian tube, usually obtained following biopsy or surgical excision. Histological classification is required, as some SOP factors apply only to specific tumour subtypes, including epithelial and mucinous tumours. 

Additional diagnoses covered by SOP

• Borderline ovarian tumour (tumour of borderline malignant potential)
• Borderline fallopian tube tumour (tumour of borderline malignant potential)
• Carcinoma-in-situ of the ovary
• Epithelial carcinoma of the ovary or fallopian tube
• Germ cell cancer of the ovary
• Sex cord-stromal tumour of the ovary
• Stromal cell cancer of the ovary

Conditions excluded from SOP

• Benign ovarian or fallopian tube neoplasm #
• Carcinoid tumour of the ovary or fallopian tube #
• Hodgkin's lymphoma of the ovary*
• Malignant neoplasm of the fallopian tube (primary)^#
• Non-Hodgkin lymphoma of the ovary or fallopian tube *
• Soft tissue sarcoma of the ovary or fallopian tube *
• Secondary (metastatic) malignancy involving the ovary or fallopian tube- code to primary site (commonly from sites such as breast, colon, gastric and pancreatic malignant neoplasms)

* another SOP applies

# non-SOP condition 

Clinical onset

Clinical onset refers to the earliest point at which symptoms or signs attributable to the malignancy first became evident. The presentation is often non- specific and may include abdominal or pelvic pain, abdominal bloating or distention, early satiety, urinary frequency, or gastrointestinal symptoms. Some tumours are detected incidentally on pelvic examination or imaging before symptoms develop. Where characteristic symptoms clearly preceded diagnosis and alternative causes have been excluded, clinical onset may be backdated accordingly. 

Clinical worsening

The only SOP worsening factor is inability to obtain appropriate clinical management.  Appropriate management can vary substantially with each case. Management depends on the tumour type, stage and extent of disease, and may include surgery, chemotherapy, targeted therapies or other systemic treatment. Determining whether worsening is attributable to an inability to obtain appropriate clinical management, rather than the natural progression of the malignancy requires specialist opinion from a gynaecological oncologist or medical oncologist.