Pulmonary blastoma is a rare primary malignancy of the lung with a small number of cases reported in children. The primary treatment is surgery, however radiotherapy and chemotherapy are also used. The ability to determine whether the tumor has been fully removed and when recurrence occurs is important for appropriate treatment and prognosis. A case of a 7-year-old girl with pulmonary blastoma is reported in which the primary tumor is extremely Ga-67-avid and in which the gallium scans were helpful in determining early recurrence and metastatic disease to the brain.