Occult ganglioneuroma with diarrhea: localization by venous catecholamines.
Neural crest tumors can be complicated by secretory diarrhea mediated by vasoactive intestinal peptide (VIP). An eight-month-old male with a several-month history of secretory diarrhea is described. Elevated urine vanillylmandelic acid (VMA), total urine catecholamines, and plasma VIP indicated that a neural crest tumor was responsible for his protracted diarrhea. An extensive search for the tumor including CT scans of his head, neck, thorax, abdomen, and pelvis was unrevealing. A selective vena caval catheterization showed elevated catecholamines in a sample obtained above the renal veins. Subsequent laparotomy disclosed a benign ganglioneuroma arising from the left adrenal; the diarrhea resolved after its removal. Selective venous sampling proved useful in establishing the tumor's location where other techniques had been unsuccessful.
D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D002395:Catecholamines / Q000097:blood*; D003968:Diarrhea, Infantile / Q000209:etiology*; D005729:Ganglioneuroma / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D014660:Vasoactive Intestinal Peptide / Q000097:blood; D014682:Vena Cava, Inferior
D002395:Catecholamines; D014660:Vasoactive Intestinal Peptide