Case report: 3D-printed model for surface mould preparation on a patient with Down's syndrome

Introduction:A patient with Down's syndrome, with dermatofibrosarcoma protuberans, was intended for adjuvant radiotherapy. The lesion was on the parietal region of the head of the patient. Given the proximity of the lesion to the brain, the curvature of the lesion, and potential complications of anaesthesia for a Down's syndrome patient, brachytherapy was the appropriate treatment. Anaesthesia complications for patients with Down's syndrome are airway infections, atlanto-occipital dislocation and bradycardia. Method:Instead of sedating the patient in order to prepare a mould applicator, a 3D-printed model of the patient's head was used. This allowed us greater time to prepare the applicator in a more relaxed environment. Result:The fit of the mould applicator on the patient was satisfactory. Minimum air gaps were observed. The treatment could be completed with sedation only. Conclusion:We were able to achieve an equivalent dose of 44 center dot 69 Gy in 5 sessions of brachytherapy, significantly reducing the anaesthesia sessions and the associated risks. A drawback of 3D printing is that it takes several hours to print the model.