We present a female with Aicardi syndrome (AS) who had infantile spasms, characteristic chorioretinal lacunae, partial agenesis of the corpus callosum, and neuronal migration abnormalities. Our patient was also diagnosed with a composite lung lesion of intralobar pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM) and developed a hepatoblastoma. This is the second report that describes the association of hepatoblastoma and AS, and the first report of pulmonary sequestration or CCAM and AS.The propositus was female and the second child born to healthy non-consanguineous Caucasian parents. The family history was unremarkable; her older sister was well and developmentally normal. An antenatal ultrasound performed at 20 weeks gestation demonstrated a pulmonary sequestration. The pregnancy proceeded to an uneventful spontaneous vaginal delivery at term. Computerized tomography performed at age 11 days to further investigate the pulmonary sequestration, demonstrated a superior hepatic mass (Fig. 1). Further investigation revealed this to be a hepatoblastoma (Fig. 2). The hepatoblastoma was successfully treated with debulking chemotherapy followed by complete resection.Infantile spasms commenced at age 5 months. Management included high dose steroids, later changed to vigabatrin. Cranial MRI revealed dysgenesis of the corpus callosum, a forme fruste of schizencephaly involving the mid body of the right lateral ventricle, foci of nodular heterotopic gray matter marginating both lateral ventricles, and polymicrogyria of the right frontal lobe. The cerebellum had a normal appearance.On examination at 6 months of age, her weight was 6.7 kg (75th centile), length was 63 cm (75th centile), and head circumference was 40 cm (25th centile). She had mild Cushing syndrome-like features, attributed to high dose steroids. She had upslanting palpebral fissures, an upturned nasal tip and a deep philtrum. She had relatively large ears and sparse eyebrows (Fig. 3).Normal investigations included a G-banded karyotype and chest X-ray demonstrating normal ribs and spine. A specialist ophthalmology opinion was sought and the presence of characteristic chorioretinal lacunae confirmed the diagnosis of AS. There was no evidence of microphthalmia, coloboma, or other optic nerve abnormalities.