CATECHOLAMINE METABOLISM IN A FUNCTIONAL NEURAL TUMOR*

Abstract

Increased excretion of norepinephrine, dopamine, 3-methoxy-4-hydroxymandelic acid and homovanillic acid was found in a 2.5 year old child with chronic diarrhea in association with a posterior mediastinal ganglioneuroma. Following operative removal of the tumor (T), all values and symptomatology returned to normal. The T contained norepinephrine and dopamine, as shown by fluorescent and chromatographic techniques, and was found incapable of forming the O-methylated metab-olites of catecholamines. Although it appears likely that the production of catecholamines by the T is related to the symptom of chronic diarrhea, the exact mechanism of this relationship awaits clarification. With the demonstration that neural T may act as functional or hormone-producing neoplasms, the determination of norepinephrine, dopamine and 3-methoxy-4-hydroxymandelic acid in the urine of such cases is recommended as an aid in diagnosis and management.