Skip to main content
Log in

Phaeochromocytoma — A laboratory experience

  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Summary

Thirteen phaeochromocytomas were found over five and a half years from 2,834 patient requests for tumour screens. HMMA (VMA) was the usual screening test requested. Free catecholamines were reported when specifically requested by clinicians and where the HMMA level was >40 μmol/24 hr. HMMA and urinary free catecholamines were estimated using HPLC with electrochemical detection in acidified 24 hr collections. Noradrenaline was elevated in all thirteen, nine had raised adrenaline and two had raised levels of all three catecholamines. Urinary free catecholamines are the most appropriate analyte package in our circumstances for the diagnosis of phaeochromocytoma. HMMA if used alone could lead to false negative diagnoses but it has a role in minimising false negatives where urinary catecholamine results are normal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kuska, J., Kokot, F., Drab, M., Drobisz, M. Frequency of incidence of particular etiological forms of arterial hypertension based on 5155 cases analysis. Kardiol. Pol. 1988; 31: 38–47.

    PubMed  CAS  Google Scholar 

  2. Ross, E. J., Griffith, D. N. W. The clinical presentation of phaeochromocytoma. Q. J. Med. 1989; 266: 485–496.

    Google Scholar 

  3. Plouin, P. F., Duclos, J. M., Menard, J., Comoy, E., Bohuon, C., Alexandre, J. M. Biochemical tests for diagnosis of phaeochromocytoma: urinary versus plasma determinations. Br. Med. J. 1981; 282: 853–854.

    Article  CAS  Google Scholar 

  4. Duncan, M. W., Compton, P., Lazarus, L., Smythe, G. A. Measurement of noradrenaline and 3,4-dihydroxyphenylglycol in urine and plasma for the diagnosis of pheochromocytoma. N. Engl. J. Med. 1988; 319: 136–142.

    PubMed  CAS  Google Scholar 

  5. Graham, P. E., Smythe, G. A., Edwards, G. A., Lazarus, L. Laboratory diagnosis of phaeochromocytoma: which analytes should we measure? Ann. Clin. Biochem. 1993; 30: 129–134.

    PubMed  Google Scholar 

  6. Bravo, E. L., Tarazi, R. C., Gifford, R.W., Stewart, B. H. Circulating and urinary catecholamines in pheochromocytoma: diagnostic and pathophysiologic implications. N. Engl. J. Med. 1979; 301: 682–686.

    PubMed  CAS  Google Scholar 

  7. FitzGibbon, M., FitzGerald, R. J., Tormey, W. P., O’Meara, A., Kenny, D. Reference values forurinary HMMA, HVA, noradrenaline, adrenaline, and dopamine excretion in children using random urine samples and HPLC with electrochemical detection. Ann. Clin. Biochem. 1992; 29: 400–404.

    PubMed  Google Scholar 

  8. Davidson, D. F., FitzPatrick, J. A simple, optimised and rapid assay for urinary free catecholamines by HPLC with electrochemical detection. Ann. Clin. Biochem. 1985; 22: 297–303.

    PubMed  CAS  Google Scholar 

  9. O’Neill, G., Tormey, W. P., Farrell, M. A., FitzGerald, R. J., Finucane, J. Phaeochromocytoma and lethal lactic acidaemia. Ir. Med. J. 1993; 86: 221.

    Google Scholar 

  10. Tormey, W. P., FitzGerald, R. F. Lack of uniformity in the clinical approach to the interpretation of urinary catecholamines and their metabolites. Ir. J. Med. Sci. 1995; 164:

  11. Moyer, T. P., Jiang, N-S., Tyce, G. M., Sheps, S. G. Analysis for urinary catecholamines by liquid chromatography with amperometric detection: methodology and clinical interpretation of results. Clin. Chem. 1979; 25: 256–263.

    PubMed  CAS  Google Scholar 

  12. Davidson, D. F. Urinary catecholamine assay by HPLC: in vitro interference by some drugs. Ann. Clin. Biochem. 1988; 25: 583–584.

    PubMed  CAS  Google Scholar 

  13. Plouin P-F., Degoulet, P., Tugaye, A., Ducrocq, M-B., Menard, J. Le depistage du pheochromocytome: chez quels hypertendus?: etude semiologique chez 2585 hypertendus dont 11 ayant un pheochromocytome. Nouv. Presse. Med. 1981; 10: 869–872.

    PubMed  CAS  Google Scholar 

  14. Sutton, M. st, Sheps, S. G., Lie, J. I. Prevalence of clinically unsuspected pheochromocytoma: review of a 50 year autopsy series. Mayo Clinic Proc. 1981; 56: 354–360.

    CAS  Google Scholar 

  15. Sardesai, S. H., Mourant, A. J., Sivathandon, Y., Farrow, R. Phaeochromocytoma and catecholamine induced cardiomyopathy presenting as heart failure. Br. Heart J. 1990; 63: 234–237.

    Article  PubMed  CAS  Google Scholar 

  16. Page, L. B., Raker, J. W., Berberich, F. R. Pheochromocytoma with predominant epinephrine secretion. Am. J. Med. 1969; 47: 648–652.

    Article  PubMed  CAS  Google Scholar 

  17. Engelman, K., Zeis, R., Waldmann, R., Mason, D. T., Sjoerdsma, A. M. Mechanism of orthostatic hypotension in pheochromocytoma. Circulation 1968; Suppl 6: 71–72.

    Google Scholar 

  18. Proye, C., Fossati, P., Fontaine, P., et al. Dopamine-secreting pheochromocytoma: an unrecognised entity? Classification of pheochromocytomas according to their type of secretion. Surgery 1986; 100: 1154–1161.

    PubMed  CAS  Google Scholar 

  19. van Vliet, P. D., Burchell, H. B., Titus, J. L. Focal myocarditis associated with pheochromocytoma. N. Engl. J. Med. 1966; 274: 1102–1108.

    PubMed  Google Scholar 

  20. Krane, N. K. Clinically unsuspected pheochromocytomas. Arch Intern. Med. 1986; 146:54–7.

    Article  PubMed  CAS  Google Scholar 

  21. Sheps, S.G., Jiang, N-S., Klee, G.G. Diagnostic evaluation of phaeochromocytoma. Endocrinol. Metab. Clin. North Am. 1988; 17: 397–414.

    PubMed  CAS  Google Scholar 

  22. Sinclair, D., Shenkin, A., Lorimer, A. R. Normal catecholamine production in a patient with a paroxysmally secreting phaeochromocytoma. Ann. Clin. Biochem. 1991; 28: 417–419.

    PubMed  Google Scholar 

  23. Sisson, J. C., Frager, M. S., Valk, T. W. et al. Scintigraphic localisation of phaeochromocytoma. N. Engl. J. Med. 1981; 305: 12–17.

    PubMed  CAS  Google Scholar 

  24. Neumann, H. P. H., Berger, D. P., Sigmund, G., Blum, U., Schmidt, D., Parmer, R. J., Volk, B., Kirste, G. Pheochromocytomas, multiple endocrine neoplasia type 2, and von Hipple-Lindau disease. N. Engl. J. Med. 1993; 329: 1531–8.

    Article  PubMed  CAS  Google Scholar 

  25. Russell, C. R., Kennedy, T. L., Kennedy, A. L., Hadden, D. R., Atkinson, A. B. Phaeochromocytoma in Northern Ireland. Ir. J. Med. Sci. 1994; 163:250.

    Google Scholar 

  26. McMillan M. Identification of hydroxytyramine in a chromaffin tumour. Lancet 1956; ii: 284.

    Article  Google Scholar 

  27. Tippett, P. A., McEwan, A. J., Ackery, D. M. A reevaluation of dopamine excretion in phaeochromocytoma. Clin. Endocrinol. 1986; 25: 401–410.

    Article  CAS  Google Scholar 

  28. O’Meara, A., Tormey, W., FitzGerald, R. J., FitzGibbon, M., Kenny, D. Interpretation of random urinary catecholamines and their metabolites in neuroblastoma. Acta Paed. 1994; 83: 88–92.

    Article  CAS  Google Scholar 

  29. O’Connor, D. T., Deftos, L. J. Secretion of chromogranin A by peptide-producing endocrine neoplasms. N. Engl. J. Med. 1986; 314: 1145–1151.

    PubMed  CAS  Google Scholar 

  30. Adrian, T., Terenghi, G., Brown, M., Allen, J., Bacarese-Hamilton, A., Polak, J., Bloom, S. Neuropeptide Y in pheochromocytomas and ganglioneuroblastomas. Lancet 1983; ii: 540–45.

    Article  Google Scholar 

  31. Weinkove, C. Measurement of catecholamines and their metabolites in urine. ACP Broadsheet No 127. J. Clin. Pathol. 1991; 44: 269–275.

    Article  PubMed  CAS  Google Scholar 

  32. Yoshioka, M., Aso, C., Amano, J., Tamura, Z., Sugi, M., Kuroda, M. Preparation of monoclonal antibodies to vanilmandelic acid and homovanillic acid. Biogenic Amines 1987; 4: 229–235.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tormey, W.P., FitzGerald, R.J. Phaeochromocytoma — A laboratory experience. I.J.M.S. 164, 142–145 (1995). https://doi.org/10.1007/BF02973282

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02973282

Keywords

Navigation