Which tumor is associated with increased VMA and HVA due to dopamine involvement?

• A. Neuroblastoma
• B. Pheochromocytoma
• C. Wilms tumor
• D. Adrenal cortical carcinoma

Answer: (A)

Catecholamine metabolites in urine reflect tumors that produce catecholamines. Neuroblastoma, arising from neural crest cells, commonly secretes dopamine. Dopamine is metabolized to homovanillic acid (HVA), and norepinephrine/epinephrine are metabolized to vanillylmandelic acid (VMA). When dopamine-producing tumors are involved, you see elevated HVA, and VMA can also be elevated due to overall catecholamine turnover. This pattern of increased both HVA and VMA is characteristic of neuroblastoma. Wilms tumor and adrenal cortical carcinoma do not typically elevate these metabolites, while pheochromocytoma can raise catecholamines and their metabolites but the dopamine link points to neuroblastoma here.