Which urine test is part of pheochromocytoma diagnostic workup?

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Measuring catecholamine production and their metabolites is how pheochromocytoma is diagnosed, because the tumor secretes excess catecholamines. In urine, the classic approach is a 24-hour collection that analyzes urinary catecholamines and their metabolites along with vanillylmandelic acid, often corrected for creatinine to account for urine concentration. This provides a comprehensive view of daily catecholamine turnover and improves diagnostic accuracy. Urine osmolality is a hydration marker and doesn’t reflect catecholamine excess. TSH levels assess thyroid function and aren’t part of pheochromocytoma workup. Plasma-free metanephrines are a sensitive test, but that is a plasma, not urine, assessment. Therefore, the urine panel that includes catecholamines, metanephrines, VMA, and creatinine best fits the urine testing component of the workup.