Do not perform urinary vanilmandelic acid and plasma and/or urinary catecholamines for diagnosing pheochromocytoma.

Type of practice

Laboratory tests

For diagnosing pheochromocytoma do perform free plasma metanephrines and, if they are not available, fractionated urinary metanephrines. Since plasma or urine metanephrines sensitivity is high, a negative result excludes pheochromocytoma, while the same conclusion is not possible catecholamines and their metabolites (e.g. urinary vanilmandelic acid).


1. Eisenhofer G (2014) Pathophysiology and diagnosis of disorders of the adrenal medulla: focus on pheochromocytoma. Compr Physiol 4: 691-713.
2. Carr JC, Spanheimer PM, Rajput M et al (2013) Discriminating pheochromocytomas from other adrenal lesions: the dilemma of elevated catecholamines. Ann Surg Oncol 20: 3855-3861.
3. Lenders JW, Pacak K, Walther MM et al (2002) Biochemical diagnosis of pheochromocytoma: which test is best? JAMA 287: 1427-1434.
4. Lenders JW, Duh QY, Eisenhofer G et al (2014) Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99: 1915-42.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.