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The critical role of angiogenesis in the growth of solid tumors, including neoplasms of the central nervous system, has provided the impetus for research leading to the discovery of inhibitors of tumor neovascularization. The therapeutic potential of systemically administered antiangiogenic drugs for brain tumors, however, is limited by a variety of anatomic and physiologic barriers to drug delivery. Implantable controlled-release polymers for local drug administration directly into the tumor parenchyma have therefore been developed to achieve therapeutic concen-trations of these drugs within the brain while minimizing systemic toxicity. With use of these polymers, successfull antiangiogenic therapy for treatment of experimental intracranial malignancies has been achieved. This has been demonstrated with a variety of otherwise unrelated drugs – including the angiostatic steroids, tetracycline derivatives, and amiloride – which modulate collagenase activity, and thus, basement membrane and interstitial matrix metabolism. Controlled‐release polymers provide a clinically practicable method of achieving sustained antian-giogenic therapy which can be readily used in combination with other treatment modalities such as cytoreductive surgery, radiation, and cytotoxic chemotherapy.

A young patient surviving four years after treatment for primary intracerebral small-cell osteosarcoma is reported. This 16-year-old girl presented with headaches, visual disturbance, and papilledema and was found to have a large, heavily calcified mass in the left parietal lobe. A gross total resection of the tumor was performed and pathologic analysis revealed a small-cell osteosarcoma. Thoracic computerized tomography (CT) scans and a complete bone scan showed no other lesions. The patient received adjuvant chemotherapy and radiotherapy. She continues to do well with no evidence of metastases or local recurrence 4 years after her initial presentation. The clinical, radiographic, surgical, pathologic, and immunohistochemical features of this case, along with therapeutic interventions and outcome, are presented.