This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
Most common presentation of neuroblastoma is ? 
Select and explain. 
A. Lytic lesion in skull with suture diasthesis, B. Lung metastasis, C. Renal invasion, D. Secondaries in brain
A: Lytic lesion in skull with suture diasthesis
Answer: A: Lytic lesion in skull with suture diasthesis 
Explanation: Ans. is 'a' i.e., Lytic lesions in skull, with sutural diastasis Most frequent site of metastasis from nueroblastoma is bone : where metastasis occurs very early. Lytic lesions in skull and sutural diastasis are manifestations of bony metastasis to skull, and hence the earliest feature, amongst the options in the questions.