A rare ganglioneuroblastoma secreting dopamine and the value of its measurement in diagnosis and prognosis

Ann Clin Biochem 2006;43:73-76
doi:10.1258/000456306775141704
© 2006 Association for Clinical Biochemistry

 

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Case Reports


M Sargazi,
ML Smith,
RC Worth and
NB Roberts


Department of Clinical Biochemistry & Metabolic Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK;
Department of Nuclear Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK;
Department of Endocrinology, Countess of Chester Hospital, Chester, UK;
Department of Clinical Biochemistry & Metabolic Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK

A case is described of a patient with a ganglioneuroblastoma, initially located in the right adrenal, which produced an excess of dopamine (7646 and 7959 nmol/24 h), approximately two and a half times the upper limit of the normal daily urine output. The urinary excretion of noradrenaline, adrenaline and methylated derivatives was always within the normal reference ranges. The patient was generally well, with normal blood pressure and only mild flushes. Two years after surgical resection, recurrence was indicated by an increase in urinary dopamine (8507 nmol/24 h); it was located in the tumour bed and left side of the neck by CT and 123I MIBG scans. The patient was treated with a high dose of 131I MIBG, with subsequent reduction in dopamine production.This was repeated on four other occasions, the latest beingin January 2005. The output of dopamine was thus used as a markerof tumour diagnosis and progression and it is recommended thatthe assay of dopamine be included in the screening of catecholamine-secretingtumours to avoid possible misdiagnosis.


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