Diagnosis of neuroblastoma by qualitative and quantitative determination of catecholamine metabolites in urine

Neuroblastoma, one of the most common solid malignant tumors of childhood, has been frequently confused with other malignancies as well as nonneoplastic diseases. The observation that neural crest tumors resulted in excretion of elevated quantities of the catecholamines and their by‐products opened the way for development of biochemical techniques for their detection. Vanillylmandelic acid, metanephrines, homovanillic acid, and 3‐methoxy‐4‐hydroxy‐phenylethyleneglycol excretions of 180 normal children were compared with those of 62 subjects suffering from illnesses commonly confused with neuroblastoma as well as 41 patients with neural crest lesions. A simple, bedside chemical technique for detecting a neuroblastoma resulted in no false positive and 91% reliability among those patients with this tumor. Although quantitative assay for 3‐methoxy‐4‐hydroxyphenylethyleneglycol appeared to offer the greatest reliability for biochemical diagnosis of neuroblastoma, broad application of the screening test might significantly improve the ease of detection and differential diagnosis of neuroblastoma.