Running Up the High Score
Very rare1.0%ObjectiveMissableSingle-player
Complete Extra Life Mode with 10 Extra Lives in your Inventory
Ofc you need to start the game in Extra Life Mode to get this. Make sure you don't die too much... (there are enough extra lives around that you can die a few times though).
This is recommended for a 2nd separate playthrough on the easiest difficulty - although you can do everything all in one run if you really want to.