All of the following are true about neuroblastoma except -

Ans. is 'c' i.e., Cafe au lait spots Neuroblastoma* Neuroblastoma is a malignant neuroendocrine tumor arising from any neural crest element of sympathetic autonomic nervous system.* It is the most common malignancy of infancy, the most common abdominal cancer in children and most common extracranial solid tumor of childhood.* Sites of involvement are adrenal medulla (most common), pelvis, cervical area (neck), posterior mediastinum, and paravertebral retroperitoneum.Clinical features* Clinical features arei) Due to mass: Abdominal (flank) mass (most common presentation), often crosses midline and displaces the kidney downwords without compressing collecting system; cervical tumor may cause Horner syndrome.ii) Due to metastasis: Orbital proptosis, Raccoan eyes (unilateral or bilateral periorbital or eyelid ecchymosis), fever, bone pain, lytic lesions in skull with sutural diastasis, spinal cord compression.iii) Due to catecholamine secretion by tumor: Tachycardia, headache, sweating, episodic diarrhea, flushing.iv) Uncommon features: Opsoclonus /opsomyoclonus, myastenia gravis.* Metastasis is present in 60-70% at the time of diagnosis. Commonest site of metastasis is skeletal system and neuroblastoma is the most common childhood malignancy metastasizes to bone. Other sites of involvement are liver, lymph nodes and skin. Lung metastasis is uncommon. Encasement of abdominal aorta and IVC may occur.