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Recurrent Pheochromocytoma with Recognition of Site of Metastasis by Means of Venous Catheterization: A Case Study

Ann Intern Med. 1964;60(1):125-130. doi:10.7326/0003-4819-60-1-125
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The presence of pheochromocytoma can be recognized with increasing reliability through the measurement of urinary and blood levels of the catecholamines and their metabolites, in addition to the standard histamine and phentolamine infusion tests (1, 2). Greater portions of the circulating hormones are excreted as 3-methoxy-4-hydroxymandelic acid (VMA), than as epinephrine and norepinephrine. Thus, the measurement of urinary VMA has become widely used to detect high circulating levels of these hormones (3). However, once the presence of such a tumor has been established, the problem of localizing it for the purposes of surgical removal may be a major one. According


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