either the head or tail/body of the pancreas.3 Although rare, these lesions are the most common pancreatic tumor in children.2 Despite their malignancy, pancreatoblastomas generally have a good prognosis. Moreover, they have a low metastatic potential, thus making resection curative.4 When metastasis does occur, the liver, lymph nodes, and/or lungs are the most common sites.2 We present a unique case of pancreatoblastoma with metastases to the brain. In January 2005 pancreatoblastoma with metastases to the liver and lymph nodes was diagnosed in this 7-year-old girl. After primary site resection and chemotherapy, she had no evidence of disease until she presented to an outside institution following a generalized seizure (June 2006). Enhanced imaging demonstrated extensive intracranial disease, and cytological studies after resection of a right frontal lesion revealed pancreatoblastoma (Fig. 1). The patient was admitted to our institution (July 2006) for systemic treatment (chemotherapy); on examination we found a symptomatic pseudomeningocele over the craniotomy site. Pseudomeningocele fluid obtained during repair revealed clusters of pancreatoblastoma cells. The girl was treated with chemotherapy, and the disease remains stable on 2-month follow-up images. Molecular events underlying the formation and metastatic dissemination of pancreatoblastomas are not completely understood, but genetic and morphological features suggest a multipotent embryological cell of origin.1,3 Treatment of this chemosensitive tumor consists of primary site resection and chemotherapy. To our knowledge, pancreatoblastoma metastasis to the central nervous system has not been previously described. Thus, the role of chemotherapy or radiotherapy in its treatment has not been defined.