Cerebral parenchymal metastasis is frequent in PPB. IT OCCURS EVEN WHEN CHEST DISEASE IS UNDER CONTROL. (See Registry Publications Priest et al. Cerebral Metastasis and other central nervous system complications of pleuropulmonary blastoma. Pediatr Blood Cancer 2007; 49:266-273). Cerebral parenchymal metastasis is the most common form of hematogenous spread. It is more common in PPB than in any other childhood solid tumor. It occurs in Type II and Type III PPB. Life-table estimates of the probability of cerebral metastasis by 5 years from diagnosis are 54% in Type III PPB and 11% in Type II PPB. Cerebral metastases occur generally in the first two years after diagnosis but up to 5 years later. In 50% of cases of cerebral metastasis, the chest disease is under complete control. Cerebral metastasis has been successfully treated. The International PPB/DICER1 Registry recommends surveillance to discover cerebral metastases as early as possible. See Health Professionals - Basics of PPB - Metastasis and Health Professionals - Recommendations - Surveillance. Or contact the Registry for more information.