Homovanillic Acid and Vanilmandelic Acid in Diagnosis of Neuroblastoma

Abstract

Neuroblastoma, a malignant tumor of childhood, originates from precursor cells of sympathetic nerve tissue or adrenal medulla. These cells produce excessive quantities of dopa, dopamine, and norepinephrine. These are converted to two major terminal urinary metabolites, homovanillic acid (HVA) and vanilmandelic acid (VMA). Seven patients with neuroblastoma were examined before treatment for urinary HVA and VMA. In six cases, the concentrations of both acids were abnormally high. An abnormally high urinary excretion of HVA, VMA, or both, has been found in 40 out of 42 cases of ganglioneuroma, ganglioneuroblastoma, or neuroblastoma, for which both acids have been measured. Simultaneous measurement of urinary HVA and VMA excretion provides an effective method for the diagnosis of a majority of these tumors and for following the results of treatment.