DIAGNOSIS OF NEURAL CREST TUMORS BY REVERSED-PHASE HIGH-PERFORMANCE LIQUID-CHROMATOGRAPHIC DETERMINATION OF URINARY CATECHOLAMINE METABOLITES

Aberrations in the metabolic pathways of catecholamines in patients with neural crest tumors result in characteristic urinary excretion patterns of their catabolites. Tumors such as pehochromocytoma, neuroblastoma and ganglioneuroma usually defy clinical diagnosis because of their rarity, small size, intraabdominal position and clinical symptoms similar to those of essential hypertension. Quantitative determinationof catecholamine metabolites such as vanillylmandelic acid (VMA) and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) offers possibilities for reliable confirmation of diagnoisis. However, previous techniques for the assessment of catabolite levels suffered from inadequate sensitivity, reproducibility or specificity, which seriously diminished their usefulness as biochemical determinants in the prognosis of these life-threatening tumors. Reported in this paper is the analysis of urinary levels of VMA and MHPG using reversed-phase hihg-performance liquid chromatography with electrochemical and spectrophotometric detection. We present the excretion patters showing these metabolites in 15 control sujects, 15 patients with pehochromocytoma and 5 patients with neuroblastoma. © 1979.