<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:An 18-month-old boy is brought to the doctors office for evaluation of abdominal pain. The boy looks emaciated and he is now significantly below his growth chart predicted weight. The family history is non-contributory. The vital signs are unremarkable. On physical examination, a non-tender mass is felt in the upper part of the abdomen. A magnetic resonance image MRI scan of his abdomen demonstrates a mass in his right adrenal gland. Biopsy of the mass demonstrates an abundance of small round blue cells. With this biopsy result, which 1 of the following findings would confirm the diagnosis?? A: Increased alpha-fetoprotein, B: MRI showing the intrarenal origin of the mass, C: Elevation of vanillylmandelic acid in the urine, D: Increased lactic dehydrogenase, E: Radiograph of the bone showing the presence of lytic bone lesion with periosteal reaction,  <response>: This is a clinical case scenario about an 18-month-old boy with abdominal pain, weight loss, and a mass in his right adrenal gland on MRI. The biopsy shows small round blue cells, suggesting a neuroendocrine tumor. The question asks which of the following findings would confirm the diagnosis. Based on the clinical presentation and biopsy results, this is most consistent with neuroblastoma. Neuroblastoma is the most common extracranial solid tumor in childhood arising from neural crest cells. Option A, increased alpha-fetoprotein, can be seen in germ cell tumors like yolk sac tumors but not neuroblastoma. Option B, showing the mass is intrarenal, would not confirm neuroblastoma which arises from the adrenal medulla. Option C, elevated vanillylmandelic acid VMA in the urine, is a breakdown product of catecholamines that can be secreted by neuroblastoma tumor cells. This would help confirm the diagnosis.Option D, increased LDH, can be seen in many malignancies and is a non-specific finding. Option E, lytic bone lesions with periosteal reaction can occur with neuroblastoma metastasis to bone, but alone would not confirm the diagnosis.C: Elevation of vanillylmandelic acid in the urine 