Urinary 5-HIAA Excretion is not Increased in Patients with Head and Neck Paragangliomas

• Published in: The International journal of biological markers Vol. 27; no. 2; pp. 160 - 163
• Main Authors: Van Hulsteijn, Leonie T., Van Duinen, Nicolette, Romijn, Johannes A., Smit, Johannes W.A., Corssmit, Eleonora P.M.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2012
• Subjects: Biomarkers, Tumor - urine; Cohort Studies; Cross-Sectional Studies; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - urine; Humans; Hydroxyindoleacetic Acid - urine; Paraganglioma - diagnosis; Paraganglioma - urine; Catecholamines; Serotonin; Head and neck paraganglioma; 5-HIAA
• ISSN: 0393-6155; 1724-6008; 1724-6008
• DOI: 10.5301/JBM.2012.9312

Background Case reports have documented carcinoid-like features in head and neck paragangliomas (HNPGLs), which, in addition to catecholamine storing granules, may also contain granules with serotonin. Serotonin is metabolized to 5-hydroxyindoleacetic acid (5-HIAA). Aim To assess the urinary excretion rates of 5-HIAA and catecholamines in HNPGL patients. Methods In 114 consecutive HNPGL patients, normetanephrine, metanephrine, norepinephrine, epinephrine, VMA, dopamine, 3-methoxytyramine and 5-HIAA excretion rates were measured in two 24-hour urinary samples. Increased excretion rates were defined as an increase of the average hormone excretion rate of 2 urine samples above the reference range. In all patients with catecholamine excess, intrathoracic and abdominal paragangliomas were excluded by 123I-MIBG scintigraphy, MRI and/or CT. Genetic screening for mutations in genes of the succinate dehydrogenase (SDH) family was performed. Results Mean urinary 5-HIAA excretion rate was 14±9 μmol/24 hours (reference range 10–44 μmol/24 hours). Urinary 5-HIAA excretion was slightly increased in only 1 patient (48 μmol/24 hours). None of the 50 patients (44%) with increased urinary excretion rates of catecholamines and/or their metabolites had elevated 5-HIAA excretion. Conclusion Urinary 5-HIAA excretion is within the normal reference range in almost all HNPGL patients. Therefore, this parameter has no clinical relevance in the routine clinical assessment of HNPGL patients.