URINARY EXCRETION OF NOREPINEPHRINE, EPINEPHRINE AND 3-METHOXY-4-HYDROXYMANDELIC ACID BY CHILDREN WITH NEURO-BLASTOMA*†

Abstract

This study concerns the urinary excretion of norepinephrine (NE), epinephrine (E) and 3-methoxy-4-hydroxymandelic acid (VMA) in 5 infants and children with neuroblastomata and 1 child with a ganglioneuroblastoma. Prior to treatment by surgery, radiation or chemotherapy (alone, or in combination), 3 of the patients excreted increased amounts of both NE and VMA. One patient excreted slightly increased amounts of NE, but VMA output was very high. Another had a normal output of VMA, but a greatly elevated output of NE. In the remaining patient, both NE and VMA excretions were normal. The output of epinephrine was not increased in any of the cases. In general, clinical improvement following therapy was associated with a drop in the urinary excretion of NE and VMA. With progression of the disease,the excretion of these compounds again increased. These findings indicate that there may be biochemical differences among neuroblastomata, even though the tumors may be of similar histologic appearance. Delineation of these differences may be important in diagnosis, prognosis and treatment.