Usually, they show limited responses to immunotherapy.1,2 By contrast, pediatric OMS typically associates with an NB of favorable prognosis and cytogenetics (absence of MYCN amplification) but rarely the Hu antibodies detected in our patient.3,4 Pediatric Hu antibody–associated LE is usually nonparaneoplastic,4 whereas paraneoplastic Hu antibody–associated CIPO is usually reported with small cell lung cancer, with only rare reports in childhood NB. Here, MYCN is linked to neuroblastoma.