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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1966 Sep;19(5):482–486. doi: 10.1136/jcp.19.5.482

Diagnostic value of detailed metabolic pathway investigations in two cases of phaeochromocytoma with minimal increase in total catecholamine output

J J Brown 1,2, C R J Ruthven 1,2, M Sandler 1,2
PMCID: PMC473355  PMID: 5919361

Abstract

Two patients with phaeochromocytoma having atypical biochemical features are described. Total catecholamine excretion was normal in one and only slightly raised in the other; both had a diagnostic rise in output of metadrenaline and 4-hydroxy-3-methoxymandelic acid whilst 4-hydroxy-3-methoxyphenylglycol excretion was increased in one of them. During hypertensive attacks adrenaline excretion became greater than that of noradrenaline. The diagnostic usefulness of separate adrenaline and noradrenaline estimations in addition to catecholamine metabolite assay is discussed. A lack of relationship between tumour catecholamine content and urinary catecholamine output is emphasized.

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Selected References

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  1. Brown J. J., Litchfield J. W., Wright A. D. Familial and multiple phaeochromocytomas. Postgrad Med J. 1966 Mar;42(485):203–206. doi: 10.1136/pgmj.42.485.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. CRAWFORD T. B. B., OUTSCHOORN A. S. The quantitative separation of adrenaline and noradrenaline in biological fluids and tissue extracts. Br J Pharmacol Chemother. 1951 Mar;6(1):8–19. doi: 10.1111/j.1476-5381.1951.tb00614.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. CROUT J. R., PISANO J. J., SJOERDSMA A. Urinary excretion of catecholamines and their metabolites in pheochromocytoma. Am Heart J. 1961 Mar;61:375–381. doi: 10.1016/0002-8703(61)90609-3. [DOI] [PubMed] [Google Scholar]
  4. CROUT J. R., SJOERDSMA A. Catecholamines in the localization of pheochromocytoma. Circulation. 1960 Oct;22:516–525. doi: 10.1161/01.cir.22.4.516. [DOI] [PubMed] [Google Scholar]
  5. ENGEL A., von EULER U. S. Diagnostic value of increased urinary output of pheochromocytoma. Lancet. 1950 Sep 23;2(6630):387–387. doi: 10.1016/s0140-6736(50)91342-0. [DOI] [PubMed] [Google Scholar]
  6. FLODING I., VON EULER U. S. Diagnosis of pheochromocytoma by fluorimetric estimation of adrenaline and noradrenaline in urine. Scand J Clin Lab Invest. 1956;8(4):288–295. doi: 10.3109/00365515609049286. [DOI] [PubMed] [Google Scholar]
  7. GITLOW S. E., MENDLOWITZ M., KHASSIS S., COHEN G., SHA J. The diagnosis of pheochromocytoma by determination of urinary 3-methoxy-4-hydroxymandelic acid. J Clin Invest. 1960 Jan;39:221–226. doi: 10.1172/JCI104022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. GITLOW S. E., MENDLOWITZ M., KRUK E., KHASSIS S. Diagnosis of pheochromocytoma by assay of catecholamine metabolites. Circ Res. 1961 May;9:746–754. doi: 10.1161/01.res.9.3.746. [DOI] [PubMed] [Google Scholar]
  9. GJESSING L. R., HJERMANN I. DIFFICULTIES IN CHEMICAL DIAGNOSIS IN PHAEOCHROMOCYTOMA. Lancet. 1964 Nov 7;2(7367):1014–1015. doi: 10.1016/s0140-6736(64)90968-7. [DOI] [PubMed] [Google Scholar]
  10. GOLDENBERG M. Adrenal medullary function. Am J Med. 1951 May;10(5):627–641. doi: 10.1016/0002-9343(51)90332-4. [DOI] [PubMed] [Google Scholar]
  11. GOLDENBERG M., SERLIN I., EDWARDS T., RAPPORT M. M. Chemical screening methods for the diagnosis of pheochromocytoma. I. Nor-epinephrine and epinephrine in human urine. Am J Med. 1954 Mar;16(3):310–327. doi: 10.1016/0002-9343(54)90349-6. [DOI] [PubMed] [Google Scholar]
  12. HAMILTON M., LITCHFIELD J. W., PEART W. S., SOWRY G. S. C. Phaeochromocytoma. Br Heart J. 1953 Apr;15(2):241–249. doi: 10.1136/hrt.15.2.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. HUNTER R. B., MARSHALL P. B., ORAM F. J. CATECHOL AMINE EXCRETION IN NORMAL PERSONS AND IN CASES OF PHAEOCHROMOCYTOMA. Q J Med. 1963 Jul;32:225–242. [PubMed] [Google Scholar]
  14. JACOBS S. L., SOBEL C., HENRY R. J. Excretion of 3-methoxy-4-hydroxymandelic acid and catecholamines in patients with pheochromocytoma. J Clin Endocrinol Metab. 1961 Mar;21:315–320. doi: 10.1210/jcem-21-3-315. [DOI] [PubMed] [Google Scholar]
  15. KELLEHER J., WALTERS G., ROBINSON R., SMITH P. CHEMICAL TESTS FOR PHAEOCHROMOCYTOMA. J Clin Pathol. 1964 Jul;17:399–404. doi: 10.1136/jcp.17.4.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. KRAUPP O., STORMANN H., BERNHEIMER H., OBENAUS H. Vorkommen und diagnostische Bedeutung von Phenolsäuren im Harn beim Phäochromocytom. Klin Wochenschr. 1959 Jan 15;37(2):76–80. doi: 10.1007/BF01482872. [DOI] [PubMed] [Google Scholar]
  17. LEATHER H. M., SHAW D. B., CATES J. E., WALKER R. M. Six cases of phaeochromocytoma with unusual clinical manifestations. Br Med J. 1962 May 19;1(5289):1373–1378. doi: 10.1136/bmj.1.5289.1373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. LITCHFIELD J. W., PEART W. S. Phaeochromocytoma with normal excretion of adrenaline and noradrenaline. Lancet. 1956 Dec 22;271(6956):1283–1284. doi: 10.1016/s0140-6736(56)91435-0. [DOI] [PubMed] [Google Scholar]
  19. LUND A. Adrenaline and noradrenaline in blood and urine in cases of pheochromocytoma. Scand J Clin Lab Invest. 1952;4(4):263–265. doi: 10.3109/00365515209060670. [DOI] [PubMed] [Google Scholar]
  20. PEART W. S. A new method of large-scale preparation of hypertensin, with a note on its assay. Biochem J. 1955 Feb;59(2):300–302. doi: 10.1042/bj0590300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. PISANO J. J. A simple analysis for normetanephrine and metanephrine in urine. Clin Chim Acta. 1960 May;5:406–414. doi: 10.1016/0009-8981(60)90146-7. [DOI] [PubMed] [Google Scholar]
  22. PISANO J. J., CROUT J. R., ABRAHAM D. Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chim Acta. 1962 Mar;7:285–291. doi: 10.1016/0009-8981(62)90022-0. [DOI] [PubMed] [Google Scholar]
  23. SANDLER M., RUTHVEN C. R. Quantitative colorimetric method for estimation of 3-methoxy-4-hydroxymandelic acid in urine; value in diagnosis of phaeochromocytoma. Lancet. 1959 Aug 15;2(7094):114–115. doi: 10.1016/s0140-6736(59)92220-2. [DOI] [PubMed] [Google Scholar]
  24. SANDLER M. THE LABORATORY INVESTIGATION OF CATECHOLAMINE-SECRETING TUMORS. J Med Lab Technol. 1964 Oct;21:306–309. [PubMed] [Google Scholar]
  25. SJOERDSMA A., LEEPER L. C., TERRY L. L., UDENFRIEND S. Studies on the biogenesis and metabolism of norepinephrine in patients with pheochromocytoma. J Clin Invest. 1959 Jan 1;38(1 Pt 1):31–38. doi: 10.1172/JCI103793. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. WILLIAMS E. D. A REVIEW OF 17 CASES OF CARCINOMA OF THE THYROID AND PHAEOCHROMOCYTOMA. J Clin Pathol. 1965 May;18:288–292. doi: 10.1136/jcp.18.3.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. von EULER U., LISHAJKO F. The estimation of catechol amines in urine. Acta Physiol Scand. 1959 Mar 31;45:122–132. doi: 10.1111/j.1748-1716.1959.tb01684.x. [DOI] [PubMed] [Google Scholar]

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