The International Neuroblastoma Risk Group Staging System (INRGSS) defines HR-NB by the presence of metastatic disease (stage M) in patients diagnosed above 12 months of age; or by the amplification of MYCN (MNA), in unresectable or metastatic tumors (stage L2, Ms and M) [2]. The gene discussed is MYCN; the disease is metastatic neoplasm.