CONTEXT: A substantial number of patients with head and neck paragangliomas (HNPGLs) have biochemically active tumors, evidenced by increased urinary excretion of catecholamines and metabolites, including 3-methoxytyramine (3MT). It is unclear whether plasma levels of these parameters are more sensitive to detect biochemical activity in HNPGL patients than urinary excretion rates. OBJECTIVE: To compare plasma free levels vs urinary excretion rates of deconjugated 3MT and combined metanephrines (MNs) in patients with HNPGL. PATIENTS AND METHODS: We included 124 consecutive patients with HNPGL for screening of catecholamine excess by measurement of 24-h urinary excretion rates of deconjugated (nor)metanephrine, (nor)epinephrine, dopamine, vanillylmandelic acid, 3MT, and plasma free levels of (nor)metanephrine and 3MT. RESULTS: Plasma free 3MT levels were increased in 35 of the 124 patients (28%), whereas 24-h urinary excretion of deconjugated 3MT was increased in 30 patients (24%) (P=0.13). Plasma free MN levels were increased in seven patients (6%) and urinary deconjugated MN levels in six patients (5%) (P=1.00). Plasma free normetanephrine (NMN) levels were increased in seven patients (6%), and five patients had increased urinary excretion of deconjugated NMN (4%) (P=0.69). Plasma free combined MN levels (NMN, MN, and 3MT) were increased in 41 patients (33%), whereas 24-h urinary excretion rates of deconjugated combined MNs were increased in 33 patients (27%, P<0.05). CONCLUSIONS: The combined levels of free MNs and free 3MT in plasma indicate a higher number of biochemically active HNPGLs than the 24-h urinary excretion rates of these markers.
CONTEXT: A substantial number of patients with head and neck paragangliomas (HNPGLs) have biochemically active tumors, evidenced by increased urinary excretion of catecholamines and metabolites, including 3-methoxytyramine (3MT). It is unclear whether plasma levels of these parameters are more sensitive to detect biochemical activity in HNPGL patients than urinary excretion rates. OBJECTIVE: To compare plasma free levels vs urinary excretion rates of deconjugated 3MT and combined metanephrines (MNs) in patients with HNPGL. PATIENTS AND METHODS: We included 124 consecutive patients with HNPGL for screening of catecholamine excess by measurement of 24-h urinary excretion rates of deconjugated (nor)metanephrine, (nor)epinephrine, dopamine, vanillylmandelic acid, 3MT, and plasma free levels of (nor)metanephrine and 3MT. RESULTS: Plasma free 3MT levels were increased in 35 of the 124 patients (28%), whereas 24-h urinary excretion of deconjugated 3MT was increased in 30 patients (24%) (P=0.13). Plasma free MN levels were increased in seven patients (6%) and urinary deconjugated MN levels in six patients (5%) (P=1.00). Plasma free normetanephrine (NMN) levels were increased in seven patients (6%), and five patients had increased urinary excretion of deconjugated NMN (4%) (P=0.69). Plasma free combined MN levels (NMN, MN, and 3MT) were increased in 41 patients (33%), whereas 24-h urinary excretion rates of deconjugated combined MNs were increased in 33 patients (27%, P<0.05). CONCLUSIONS: The combined levels of free MNs and free 3MT in plasma indicate a higher number of biochemically active HNPGLs than the 24-h urinary excretion rates of these markers.
Authors: Thamara E Osinga; Thera P Links; Robin P F Dullaart; Karel Pacak; Anouk N A van der Horst-Schrivers; Michiel N Kerstens; Ido P Kema Journal: FASEB J Date: 2017-03-06 Impact factor: 5.191
Authors: David Taïeb; Alexandre Kaliski; Carsten C Boedeker; Victoria Martucci; Tito Fojo; John R Adler; Karel Pacak Journal: Endocr Rev Date: 2014-07-17 Impact factor: 19.871
Authors: Hilary C McCrary; Eric Babajanian; Matias Calquin; Patrick Carpenter; Geoffrey Casazza; Anne Naumer; Samantha Greenberg; Wendy Kohlmann; Richard Cannon; Marcus M Monroe; Jason P Hunt; Luke Buchmann Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-07-01 Impact factor: 6.223
Authors: Henrique Vara Luiz; Mary Jane Tanchee; Maria G Pavlatou; Run Yu; Joan Nambuba; Katherine Wolf; Tamara Prodanov; Robert Wesley; Karen Adams; Tito Fojo; Karel Pacak Journal: Clin Endocrinol (Oxf) Date: 2016-04-15 Impact factor: 3.478
Authors: Laurence Amar; Karel Pacak; Olivier Steichen; Scott A Akker; Simon J B Aylwin; Eric Baudin; Alexandre Buffet; Nelly Burnichon; Roderick J Clifton-Bligh; Patricia L M Dahia; Martin Fassnacht; Ashley B Grossman; Philippe Herman; Rodney J Hicks; Andrzej Januszewicz; Camilo Jimenez; Henricus P M Kunst; Dylan Lewis; Massimo Mannelli; Mitsuhide Naruse; Mercedes Robledo; David Taïeb; David R Taylor; Henri J L M Timmers; Giorgio Treglia; Nicola Tufton; William F Young; Jacques W M Lenders; Anne-Paule Gimenez-Roqueplo; Charlotte Lussey-Lepoutre Journal: Nat Rev Endocrinol Date: 2021-05-21 Impact factor: 43.330