Neuroblastoma accounts for 7% of malignancies from birth to 14 years of age1,2 and 12% of cancer deaths in children.3 Over 40% of neuroblastomas are considered high risk4 and >50% of patients survive.5 One important factor in defining high-risk disease is amplification of the N-MYC gene.1,6,7 Stage IV disease with N-MYC amplification has a 25–30% 5-year survival rate.1 The N-MYC gene has been estimated to be amplified in 15–25% of neuroblastomas,8,9 yet the mechanisms by which it drives pathophysiology remain elusive. The gene discussed is MYCN; the disease is neuroblastoma.