However, a low level of manganese superoxide dismutase activity in malignant pheochromocytoma may be a marker for malignancy of this neoplasm. Measurement of plasma methoxyamines is aimed to provide a reliable plasma marker readily available for any patient suspected of having a pheochromocytoma. The analytical specificity is excellent. Among most usual antihypertensive drugs, only conversion enzyme inhibitors and diuretics induce in some patients a moderate increase of NMN with minor consequence in values interpretation. The kidney plays a major role in the blood clearance of methoxyamines and any alteration of renal function is associated to the increase of plasma methoxyamine levels.
Malignant pheochromocytoma has a low incidence.
Metastatic disease with skeletal spread is a known entity while osseous involvement of the spine is uncommon. Therefore the case of a 27 year of female with successive, polytopic spinal metastases is reported who underwent surgical resection and stabilisation. 6 years after onset of spinal metastases and operative treatment the patient is free of complaints according to the spinal column. The present study reports on a case of paraganglioma of the urinary bladder and briefly reviews the literature. The patient presented with gross hematuria and no history of hypertension.