VMA is elevated in which of the following condition?
High-Yield Explanation
VMA elevated in overproduction of catecholamines Source of these catecholamines (adrenal glandaadrenal medulla) Tumor associated with it is pheochromocytoma VMA is screening test in a patient suspected to be suffering from pheochromocytoma Only 10% of pheochromocytoma are malignant (adrenal origin) The chances of extra adrenal pheochromocytoma becomes malignant (30-40%) The tumors are composed of clusters of polygonal to spindle shaped chromaffin cells or chief cells that are surrounded by suppoing sustentacular cells, creating small nests or alveoli (zellballen) that are supplied by a rich vascular network The cytoplasm has a finely granular appearance, best demonstrated with silver stains, due to the presence of granules containing catecholamines. The nuclei are usually round to ovoid, with a stippled "salt and pepper" chromatin that is characteristic of neuro endocrine tumors