A patient with MYCN amplified neuroblastoma with high mutation signature 3 (BRCA1/2) exposure (89th percentile in the pediatric cohort) had a germline heterozygous PALB2 missense mutation (p.R663C), also heterozygous in tumor, supporting a PARP inhibitor therapy recommendation (LOE5B) which was not pursued. This evidence concerns the gene MYCN and neoplasm.