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Article: The importance of the interpretation of urine catecholamines is essential for the diagnosis and management of patient with dopamine-secreting paraganglioma

TitleThe importance of the interpretation of urine catecholamines is essential for the diagnosis and management of patient with dopamine-secreting paraganglioma
Authors
Issue Date2005
PublisherRoyal Society of Medicine Press Ltd. The Journal's web site is located at http://www.roysocmed.ac.uk/pub/acb.htm
Citation
Annals Of Clinical Biochemistry, 2005, v. 42 n. 1, p. 73-77 How to Cite?
AbstractPhaeochromocytoma or paraganglioma that exclusively secretes dopamine is very rare. This case illustrates its atypical presentation and the importance of interpretative reporting for urine catecholamines leading to the diagnosis and subsequent management of a patient with this condition. We report a 71-year-old Chinese woman with a large dopamine-secreting paraganglioma. She presented with low back pain for six months. On examination, a right abdominal mass was palpable incidentally. Her blood pressure was normal throughout. Serial 24-h urine collections for catecholamines showed enormous elevation of urine dopamine excretion to 80.7 μmol/day (normotensive: <2.6 μmol/day). However, the daily excretions of urine adrenaline and noradrenaline, as well as their metabolites were within their respective reference intervals. Good communication between chemical pathologists and physicians prompted the arrangement of the whole body 131I-meta-iodobenzylguanidine (MIBG) scintigraphy, which showed a large signal in the right upper quadrant of the abdomen corresponding to a large extra-adrenal tumour detected by both ultrasonography and computerized tomography (CT) of the abdomen. Histological section of the tumour tissue revealed paraganglioma, which stained positive for chromogranin and neuron-specific enolase. After four months, the patient presented with chest symptoms and CT of the thorax revealed multiple nodules. Lung metastases were suspected. However, follow-up urine catecholamine and dopamine excretions were again within their respective normotensive reference intervals. A second MIBG scintigraphy was performed, but no specific uptake at either the thorax or the abdomen could be demonstrated. Fine-needle aspiration cytology using the thoracoscopic technique was performed and immunochemical staining of the biopsy specimen showed the presence of non-small-cell carcinoma of the lung.
Persistent Identifierhttp://hdl.handle.net/10722/148390
ISSN
2023 Impact Factor: 2.1
2023 SCImago Journal Rankings: 0.598
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTam, Ven_US
dc.contributor.authorNg, KFen_US
dc.contributor.authorFung, LMen_US
dc.contributor.authorWong, YYen_US
dc.contributor.authorChan, MHMen_US
dc.contributor.authorLam, CWen_US
dc.contributor.authorTam, Sen_US
dc.contributor.authorLam, CWKen_US
dc.date.accessioned2012-05-29T06:12:40Z-
dc.date.available2012-05-29T06:12:40Z-
dc.date.issued2005en_US
dc.identifier.citationAnnals Of Clinical Biochemistry, 2005, v. 42 n. 1, p. 73-77en_US
dc.identifier.issn0004-5632en_US
dc.identifier.urihttp://hdl.handle.net/10722/148390-
dc.description.abstractPhaeochromocytoma or paraganglioma that exclusively secretes dopamine is very rare. This case illustrates its atypical presentation and the importance of interpretative reporting for urine catecholamines leading to the diagnosis and subsequent management of a patient with this condition. We report a 71-year-old Chinese woman with a large dopamine-secreting paraganglioma. She presented with low back pain for six months. On examination, a right abdominal mass was palpable incidentally. Her blood pressure was normal throughout. Serial 24-h urine collections for catecholamines showed enormous elevation of urine dopamine excretion to 80.7 μmol/day (normotensive: <2.6 μmol/day). However, the daily excretions of urine adrenaline and noradrenaline, as well as their metabolites were within their respective reference intervals. Good communication between chemical pathologists and physicians prompted the arrangement of the whole body 131I-meta-iodobenzylguanidine (MIBG) scintigraphy, which showed a large signal in the right upper quadrant of the abdomen corresponding to a large extra-adrenal tumour detected by both ultrasonography and computerized tomography (CT) of the abdomen. Histological section of the tumour tissue revealed paraganglioma, which stained positive for chromogranin and neuron-specific enolase. After four months, the patient presented with chest symptoms and CT of the thorax revealed multiple nodules. Lung metastases were suspected. However, follow-up urine catecholamine and dopamine excretions were again within their respective normotensive reference intervals. A second MIBG scintigraphy was performed, but no specific uptake at either the thorax or the abdomen could be demonstrated. Fine-needle aspiration cytology using the thoracoscopic technique was performed and immunochemical staining of the biopsy specimen showed the presence of non-small-cell carcinoma of the lung.en_US
dc.languageengen_US
dc.publisherRoyal Society of Medicine Press Ltd. The Journal's web site is located at http://www.roysocmed.ac.uk/pub/acb.htmen_US
dc.relation.ispartofAnnals of Clinical Biochemistryen_US
dc.subject.mesh3-Iodobenzylguanidine - Diagnostic Useen_US
dc.subject.meshAdrenal Gland Neoplasms - Diagnosis - Secretionen_US
dc.subject.meshAgeden_US
dc.subject.meshCarcinoma, Non-Small-Cell Lung - Diagnosis - Secondary - Secretionen_US
dc.subject.meshDopamine - Secretionen_US
dc.subject.meshEpinephrine - Urineen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIodine Radioisotopes - Diagnostic Useen_US
dc.subject.meshLung Neoplasms - Diagnosis - Secondary - Secretionen_US
dc.subject.meshNorepinephrine - Urineen_US
dc.subject.meshParaganglioma - Diagnosis - Secretionen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.titleThe importance of the interpretation of urine catecholamines is essential for the diagnosis and management of patient with dopamine-secreting paragangliomaen_US
dc.typeArticleen_US
dc.identifier.emailLam, CW:ching-wanlam@pathology.hku.hken_US
dc.identifier.authorityLam, CW=rp00260en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1258/0004563053026916en_US
dc.identifier.pmid15802039-
dc.identifier.scopuseid_2-s2.0-13444267339en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-13444267339&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume42en_US
dc.identifier.issue1en_US
dc.identifier.spage73en_US
dc.identifier.epage77en_US
dc.identifier.isiWOS:000226883400016-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.citeulike91453-
dc.identifier.issnl0004-5632-

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