This test measures the amount of Vanillylmandelic Acid (VMA), the principal end product of catecholamine (adrenaline and noradrenaline) metabolism secreted by the adrenal gland and sympathetic nerves. It is measured in a 24-hour urine collection. An elevated level of VMA in urine is a classic biochemical marker for chromaffin cell tumors, such as Pheochromocytoma in the adrenal gland and Neuroblastoma in children.