Epithelioid Type Tongue Rhabdomyosarcoma in a Pediatric Patient: A Case Report With Literature Review.

Tongue rhabdomyosarcomas (RMSs) are extremely rare soft tissue tumors in the pediatric age group. The most common reported histopathology type is embryonal. To our knowledge, epithelioid type has not yet been reported in tongue RMSs. We report a case of an eight-year-old boy who presented with a painless tongue mass, and the biopsy demonstrated RMS epithelioid type. Head magnetic resonance imaging (MRI) was performed and showed peripherally enhancing mass with central cystic/necrotic component. Computed tomography (CT) scan of the neck showed involvement of the cervical lymph nodes, while metastatic workup was negative for malignancy. As the biopsy showed a positive margin, the patient underwent secondary resection. Moreover, he received adjuvant chemotherapy and radiotherapy. There was no evidence of the disease, and no metastasis was detected in a follow-up of three years. We also performed a literature review of pediatric tongue RMSs to assess the clinical presentation, histopathology, diagnosis, and management.

Factors influencing the mental health of caregivers of children with cerebral palsy.

Objectives: Caregivers of children with cerebral palsy have a huge burden which might affect their mental health. This study aimed to determine the different factors affecting the mental health of caregivers of children with cerebral palsy and to raise awareness among healthcare providers. Methods: A cross-sectional study was conducted among caregivers of children with cerebral palsy in National Guard Health Affairs-Jeddah, Saudi Arabia, using the Depression Anxiety Stress Scale-21, which is a validated questionnaire that assesses: depression, anxiety, and stress. This questionnaire was used to assess the mental health of the caregivers. In addition, factors that reflected the child's health condition, such as visual impairment, number of emergency department visits, and number of Pediatric Intensive Care Unit admissions were also reported to investigate the impact on the caregiver's mental health. Results: The study sample consisted of 40 caregivers, of which 72.5% were mothers. According to the Depression Anxiety Stress Scale-21 score, 12.5% (n = 5) of the caregivers had moderate depression scores, 10% (n = 4) revealed extremely severe depression, and 10% (n = 4) showed moderate anxiety. Furthermore, 12.5% (n = 5), 15% (n = 6), and 7.5% (n = 3) of the caregivers have scored as moderate, severe, and extremely severe stress levels, respectively. Caregivers' depression, anxiety, and stress scores were significantly (p ≤ 0.05) associated with the impact of vision of their dependent children, frequent hospital admissions, and frequent emergency department visits. Increased Pediatric Intensive Care Unit admissions in the past year were also significantly associated with higher caregiver anxiety scores. Conclusion: To the best of our knowledge, the dimension of caregivers' stress and anxiety and their association with the children's dependency level is not well documented in our region. Caregivers of children with cerebral palsy reported having mental health challenges associated with the children's visual impairment, frequent need for acute medical care, and hospital admissions. Healthcare workers should provide early and proactive planning of medical and social support for children with cerebral palsy and their families using a family-centered approach.