THE VALUE OF SERIAL CATECHOLAMINE DETERMINATIONS IN CHILDREN WITH NEUROBLASTOMA

Abstract

Urinary catecholamine excretion was measured in a 4-year-old child with neuroblastoma arising from the right adrenal. Initially urinary dopamine and norepinephrine output was high. Because the tumor was inoperable a course of radiation therapy and chemotherapy was given. Following this treatment catecholamine excretion decreased but never reached normal levels. Although there was no clinical evidence of persistent tumor, the elevated urinary output of dopamine and norepinephrine indicated residual neuroblastoma. Therefore surgical exploration was performed and tumor was found overlying the superior pole of the right kidney. After removal of this persistent neuroblastoma the urinary excretion of catecholamines returned to normal and remained at this level. The child has no evidence of recurrent disease and appears healthy. To our knowledge this represents the first reported case wherein the indication for surgical removal of residual neuroblastoma was based solely on elevated output of urinary catecholamines.