PEDIATRICS Vol. 79 No. 2 February 1987, pp. 203-205
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Three Years of Experience With Random Urinary Homovanillic and Vanillylmandelic Acid Levels in the Diagnosis of Neuroblastoma

Mendel Tuchman MD1, Margaret L. R. Ramnaraine BS1, William G. Woods MD1, and William Krivit MD, PhD1

1 From the Divisions of Metabolism and Oncology, Department of Pediatrics, University of Minnesota, Minneapolis

During the last 3 years, random urine samples from 408 patients were tested for elevated homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels to rule out the diagnosis of neuroblastoma. Thirty-seven of these patients had elevated HVA and/or VMA levels, and neuroblastoma was subsequently diagnosed. In three additional patients with negative test results (normal HVA and VMA levels), tumors were subsequently diagnosed (false-negative rate of 7.5%). Ten percent of the patients with neuroblastoma had normal HVA and 27.5% had normal VMA levels at the time of diagnosis. Only one patient (2.5%) with neuroblastoma had elevated VMA levels in the presence of normal HVA levels. More than 60% of the patients with neuroblastoma had urinary HVA and/or VMA levels higher than twice the upper limit of normal. No false-positive results were encountered. Age and stage distributions of the patients are shown, and the significance of the results is discussed.

Key Words: neuroblastoma • homovanillic acid • vanillymandelic acid • catechcholamine

Submitted on January 17, 1986
Accepted on April 28, 1986