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İstanbul Üniv. Onkoloji Enstitüsü, Radyasyon Onkolojisi BD Extraneural spread in primary intracranial tumors is rare. In paediatric age group the rate of extra central nervous system (CNS) spread is somewhat higher (% 2.3), most of which accounts for medulloblastoma. The most common site of extra CNS involvement is the skeletal system. This is followed by bone marrow, pulmonary and hepatic systems. Lymphatic spread is rare. A young female, when aged 15 was operated and consequently irradiated for a posterior fossa tumor and was diagnosed as medulloblastoma. 4 year following this treatment there was a local relapse. A relapse operation and second course of posterior fossa irradiation was performed which was followed by systemic chemotherapy. During the third course there appeared lymph node enlargement on the left cervical site. Modified left neck dissection showed there was histologically confirmed lymphatic spread. Keywords :