Inclusion Criteria

Inclusion:

- Patients with recurrent primary malignant brain tumors.

- Patient must have been previously treated with external beam radiation, which is the
standard of care.

- An MR scan must be obtained within 30 days of enrollment and must demonstrate an
enhancing mass without significant mass effect. Tumors must be ≤ 100cc in total
volume. The lesion must be stereotactically accessible.

- Patient must have demonstrated evidence of increasing contrast enhancement on MR or
CT imaging while on stable or increasing dose of steroid.

- Karnofsky performance score of greater than or equal to 60.

- Men and women of child-bearing potential must practice birth control. Women of child
bearing age must have a negative serum or urine pregnancy test within 7 days of study
entry.

- Patient must possess the ability to give Informed Consent. Parent or guardian may
give informed consent for minors.

- Patient must be willing to and medically capable of undergoing the surgical
operation.

- Patients may not be receiving other investigational agent for the treatment of
malignant brain tumor.

- Patients must be at least 1 year old to participate in the study.

Exclusion:

- Patients with diffuse subependymal or CSF disease.

- Patients with tumors involving the cerebellum, or both hemispheres.

- Patients with an active infection requiring treatment or having an unexplained
febrile illness.

- Patients who are known HIV positive or who are known positive for Hepatitis B or C
virus

- Patients who have received any form of radiation or chemotherapy within 4 weeks of
protocol enrollment.

- Patients with systemic diseases which may be associated with unacceptable
anesthetic/operative risk.

- Patients who have previously received systemic topotecan for their tumor

- Patients less than 1 year of age

- Patients who are not able to receive an MRI scan