Stage 4 neuroblastoma is divided into stages 4 and 4S. In stage 4, the tumor has spread to distant lymph nodes, the skin, and/or other parts of the body. In stage 4S, (1) the child is younger than 1 year; and (2) the cancer has spread to the skin, liver, and/or bone marrow; and (3) the tumor is in one area only and all of the tumor that can be seen may be completely removed during surgery; and/or (4) cancer cells may be found in the lymph nodes near the tumor.