What metabolic disorder is indicated by a boiled cabbage urine odor?

The metabolic disorder associated with a boiled cabbage odor in urine is specifically influenced by the presence of certain organic compounds that are byproducts of metabolic processes. In this case, tyrosinemia is characterized by an accumulation of tyrosine and its metabolites due to a deficiency in the enzymes responsible for its breakdown. One of these metabolites, specifically p-hydroxyphenylacetate, can impart a distinctive odor that resembles boiled cabbage.

In contrast, the other conditions listed have different characteristic odors or clinical presentations. Homocystinuria, for example, presents with a more generic or "scentless" profile but is not linked to the specific cabbage-like odor. Cystinuria tends to present with a strong sulfurous odor associated with cystine crystals in the urine, and maple syrup urine disease is marked by a sweet odor reminiscent of maple syrup, owing to the accumulation of branched-chain amino acids. Each of these disorders has its unique biochemical pathways and presentations, which is why identifying the specific odor can help in narrowing down the diagnosis to tyrosinemia in this case.