Other elements and interaction between these elements certainly play also a significant role in the pathogenesis of neuroblastoma.5, 6, 7, 8 Among the recurrent somatic mutations in chromatin remodelers, ATRX mutations are associated with high-risk disease, older age at diagnosis, and poor prognosis in MYCN amplified neuroblastoma.8, 9, 10, 11. This evidence concerns the gene MYCN and neuroblastoma.