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# A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Vanillylmandelic Acid (VMA), 24 Hr Urine (VMA)
Test Code: VMASO
Synonyms/Keywords
Vanillylmandelic Acid
3-Methoxy-4-Hydroxymandelic Acid
4-Hydroxy-3-Methoxymandelic Acid
VMA
Neuroblastoma Profile
Useful For
Screening children for catecholamine-secreting tumors with a 24-hour urine collection when requesting testing for only vanillylmandelic acid
 
Supporting a diagnosis of neuroblastoma
 
Monitoring patients with a treated neuroblastoma
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Urine ​Urine Plastic Container ​5 mL ​4 mL ​2 mL
Collection Processing Instructions
Patient Preparation: Administration of L-dopa may falsely increase homovanillic acid results; it should be discontinued 24 hours prior to and during collection of specimen.
Collection Instructions:
1.      Collect a 24-hour urine specimen. 
2.      Collection duration and urine volume are required.
3.      Patient’s age is required.
4. Add 25 mL of 50% acetic acid as preservative at start of collection. If specimen is refrigerated during collection, preservative may be added up to 12 hours after collection. Use 15 mL of 50% acetic acid for children less than 5 years old. This preservative is intended to achieve a pH of between approximately 1 and 5. If necessary, adjust urine pH to 1 to 5 with 50% acetic or HCI acid.
Additional Information:
All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and homovanillic acid (HVA) tests are ordered.
Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.
Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​Refrigerate (preferred) ​28 days
​Frozen ​180 days
Interference
All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and homovanillic acid (HVA) tests are ordered.
Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday, 8am ​2 days SPE Methodology;  Analysis by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
Test Information
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
 
Vanillylmandelic acid (VMA) and other catecholamine metabolites (homovanillic acid [HVA] and dopamine) are typically elevated in patients with catecholamine-secreting tumors (eg, neuroblastoma, pheochromocytoma, and other neural crest tumors). VMA and HVA levels may also be useful in monitoring patients who have been treated as a result of 1 of the above-mentioned tumors
Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories <1 year: <25.0 mg/g creatinine
1 year: <22.5 mg/g creatinine
2-4 years: <16.0 mg/g creatinine
5-9 years: <12.0 mg/g creatinine
10-14 years: <8.0 mg/g creatinine
> or =15 years (adults): <8.0 mg/24 hours
Interpretation
Vanillylmandelic acid and/or homovanillic acid concentrations are elevated in most patients (more than 90%) with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition. Additional confirmatory testing is required.
 
A normal result does not exclude the presence of a catecholamine-secreting tumor.
 
Elevated values are suggestive of a pheochromocytoma, but they are not diagnostic
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​84585 ​1
Classification
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
Synonyms/Keywords
Vanillylmandelic Acid
3-Methoxy-4-Hydroxymandelic Acid
4-Hydroxy-3-Methoxymandelic Acid
VMA
Neuroblastoma Profile
Ordering Applications
Ordering Application Description
​Centricity ​Vanillylmandelic Acid (VMA), 24 Hr Urine (VMA)
​Cerner ​Vanillylmandelic Acid (VMA), 24 Hr Urine (VMA)
​COM ​Vanillylmandelic Acid (VMA), 24 Hr Urine (VMA)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Urine ​Urine Plastic Container ​5 mL ​4 mL ​2 mL
Collection Processing Instructions
Patient Preparation: Administration of L-dopa may falsely increase homovanillic acid results; it should be discontinued 24 hours prior to and during collection of specimen.
Collection Instructions:
1.      Collect a 24-hour urine specimen. 
2.      Collection duration and urine volume are required.
3.      Patient’s age is required.
4. Add 25 mL of 50% acetic acid as preservative at start of collection. If specimen is refrigerated during collection, preservative may be added up to 12 hours after collection. Use 15 mL of 50% acetic acid for children less than 5 years old. This preservative is intended to achieve a pH of between approximately 1 and 5. If necessary, adjust urine pH to 1 to 5 with 50% acetic or HCI acid.
Additional Information:
All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and homovanillic acid (HVA) tests are ordered.
Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.
Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​Refrigerate (preferred) ​28 days
​Frozen ​180 days
Interference
All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and homovanillic acid (HVA) tests are ordered.
Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.
Useful For
Screening children for catecholamine-secreting tumors with a 24-hour urine collection when requesting testing for only vanillylmandelic acid
 
Supporting a diagnosis of neuroblastoma
 
Monitoring patients with a treated neuroblastoma
Test Information
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
 
Vanillylmandelic acid (VMA) and other catecholamine metabolites (homovanillic acid [HVA] and dopamine) are typically elevated in patients with catecholamine-secreting tumors (eg, neuroblastoma, pheochromocytoma, and other neural crest tumors). VMA and HVA levels may also be useful in monitoring patients who have been treated as a result of 1 of the above-mentioned tumors
Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories <1 year: <25.0 mg/g creatinine
1 year: <22.5 mg/g creatinine
2-4 years: <16.0 mg/g creatinine
5-9 years: <12.0 mg/g creatinine
10-14 years: <8.0 mg/g creatinine
> or =15 years (adults): <8.0 mg/24 hours
Interpretation
Vanillylmandelic acid and/or homovanillic acid concentrations are elevated in most patients (more than 90%) with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition. Additional confirmatory testing is required.
 
A normal result does not exclude the presence of a catecholamine-secreting tumor.
 
Elevated values are suggestive of a pheochromocytoma, but they are not diagnostic
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday, 8am ​2 days SPE Methodology;  Analysis by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​84585 ​1
Classification
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
For most current information refer to the Marshfield Laboratory online reference manual.