Of note, no abnormalities involving genes previously described in familial cases of NBL, such as paired-like homeobox 2B (PHOX2B), and the anaplastic lymphoma kinase (ALK) were identified here, also supporting its sporadic nature.17 It is interesting that for the twins, tumour preferentially metastasised to similar organs (e.g. liver, bone marrow), which is the pattern for stage MS NBL. Here, ALK is linked to neoplasm.