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Disparate urinary catecholamine patterns in secondary hypertension due to unique sequential development of
C Amodeo1, J Perez, B C Sturgill
1Department of Internal Medicine, University of Virginia Medical Center, Charlottesville 22908.
Abstract:
A 43-year-old white woman had a pheochromocytoma removed from her left adrenal gland, and one year later she developed a new left upper abdominal mass that was found to be a neuroblastoma. On both occasions, urinary vanillylmandelic acid level was elevated. However, urinary norepinephrine and epinephrine levels were increased only during the pheochromocytoma episode, while the urinary homovanillic acid level was elevated only when neuroblastoma developed. Despite a high suspicion of pheochromocytoma recurrence, the urinary catecholamine profile was suggestive of neuroblastoma, which was revealed by histopathologic analysis of the tumor tissue.