The LaBrosse Spot Test: A Practical Aid in the Diagnosis and Management of Children with Neuroblastoma

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Abstract
Measurement of vanillylmandelic acid (4-hydroxy-3 methoxy-mandelic acid or VMA) in the urine of patients with neuroblastoma has become part of the routine work up, since its presence was described by Voorhess and Gardner in 1960.1 When quantitative measurements of this catecholamine metabolite are performed, the patient must be placed on a strict diet for 2 to 3 days to eliminate substances whose breakdown products appear in the urine and give false positive results. The numerous items which must be excluded are beverages such as tea, colas, and Kcol-Aid, desserts and pastries flavored with chocolate and vanilla, and a variety of fruits including oranges, bananas, grapes, and tomatoes.

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