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1. The possible diagnosis for Kai is Neurofibromatosis Type 1 (NF1). Symptoms of NF1 are cafe-au-lait spots (the dark spots found on Kai's body), eye abnormalities (spots found in Kai's eyes), headaches (Kai has headaches sometimes), and learning disabilities (Kai has difficulty focusing in school).

2. To proceed for his care, we must conduct a biopsy to determine if those bumps found on his leg are benign tumors, get an MRI scan, advise treatments for headache and attention span, and continue to monitor Kai.

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1. One possible diagnosis may be Neuroblastoma. Neuroblastoma is a cancer that is commonly found in children under the age of 10. It is often seen as a bump under the skin; neuroblastoma tumors are typically small and solid. This cancer can cause changes to the eyes, though they usually result in dark circles under the eyes, not necessarily spots in the iris. To test this diagnosis, a tumor biopsy must be conducted in order to identify the types and patterns in the cells.

2. Another possible diagnosis could be Soft Tissue Sarcoma. Sarcoma is a type of tumor that affect muscles, ligaments, tendons, along with many other soft tissues of the body. It typically effect your arms, legs, and chest. Because Kai Rossi's tumors are located on his legs, it is a possibility. Along with the fact that they are solid, and not fluid filled tumors. To test this diagnosis, a tumor biopsy must be conducted in order to identify the types and patterns in the cells.

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A possible diagnosis for Kai is neurofibromatosis type 1 (NF1). NF1 is a genetic nervous system disorder. The solid bumps on the back of Kai's legs could be benign tumors that grow on nerves under the skin from NF1. The dark patches on his skin may be café-au-lait spots which are light brown patches on the skin commonly caused by NF1. The dark spots in Kai's iris could be Lisch nodules - small, pigmented dots common with NF1. Children who have this disease also commonly have learning difficulties which aligns with Kai's trouble focusing. Headaches can also occur if the tumors affect the brain or nerves. This disease also does not normally affect vital signs which is why Kai's are normal. Doctors might use an MRI on Kai to show tumors on nerves or brain. They could also use a CT scan on him to show tumors. Even though NF1 is genetic, parents may show very mild symptoms or none.

Another possible diagnosis is Tuberous Sclerosis Complex (TSC). TSC is another genetic disease. The bumps on his leg could be benign tumors that form on or under the skin. The dark spots on his skin are also a symptom of TSC. TSC can also cause retinal hamartomas which explains Kai's dark spots in his eyes. Sometimes children with this condition can have learning difficulties such as Kai. Headaches are also a symptom. This disease can also occur spontaneously in children without showing in parents. For this disease, doctors should use MRI or CT scan to detect tumors.

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One possible diagnosis is Neurofibromatosis Type 1 (NF1), a common genetic disorder that causes tumors to grow on nerves throughout the body. This is a possible diagnosis because Kai has multiple dark spots which are solid masses under his skin as shown on the MRI, under his leg, on his shoulder, and around his body which are most likely cafe au lait spots (CALS). He also has possible Lisch nodules, which are small, brownish spots on his iris’s surface, and headaches possibly from tumors affecting nerves on the brain which would affect his focus during school. To test for this diagnosis, he would need a further physical examination to count and measure cafe au lait spots and check for other symptoms such as freckles. He would also need an opthalmologic exam to confirm lisch nodules, genetic testing through a blood test for the NF1 gene, and a biopsy to determine if the tumor is a neurofibroma.

Another possible diagnosis is Lipomas, which are benign tumors made of fat tissue that can occur as soft bumps under the skin. This is a possible diagnosis because Kai has solid masses under his skin as confirmed by his MRI. Lipomas also correlate with his other symptoms, as if they grow near nerves, they could cause headaches or discomfort. To test for it, he would need a further physical examination to determine if the bumps feel soft and movable, diagnosing for a certain type of lipomas, an ultrasound to determine if the masses are made up of fat tissue, and a biopsy to confirm that the cells are fatty tissue.

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Kai Rossi is a 7-year-old male who presented with unexplained bumps underneath the skin. Rossi also has dark grey spots on the iris of his eye; he reports occasional headaches which is treated with acetaminophen as needed. Rossi's mother also reports that Rossi has trouble sitting and focusing on school. Rossi's poor attention in school may be a sign of attention deficit hyperactivity disorder (ADHD). ADHD is a common neurodevelopment disorder that typically begins in childhood. An MRI was ordered to inspect the bumps of Rossi's legs. The MRI results revealed that the bumps are solid and have no fluid in them, further testing is necessary to determine if the bumps are benign or malignant.

Possible Differential Diagnosis

1) A possible diagnosis for Kai Rossi is Neurofibromatosis type 1 (NF1). Neurofibromatosis type 1 is a genetic condition that causes changes in skin pigment and tumors on nerve tissue. The tumors are not cancerous, known as benign tumor, however they can become cancerous. NF1 is very rare and is usually diagnosed before the age of 10 years old. A symptom of NF1 is ADHD which could also be the reason for his attention problems in school. More symptoms include flat light brown spots on the skin which Rossi has, soft pea-sized bumps on or under the skin called neurofibromas. Rossi's unexplained bumps could be neurofibromas caused by NF1. NF1 is also causes people to be shorter than normal, which also relates to Rossi because he is 3' 7" and the average height of a 7-year-old is 4'. Tiny bumps called Lisch nodules which are bumps on the iris of the eye is another symptom of NF1, this could explain the dark spots on Rossi's eye. Lots of Rossi's symptoms and traits align with the diagnosis of NF1. To officially confirm Rossi has NF1 he must undergo genetic testing, NF1 is caused by an altered NF1 gene on chromosome 17. Genetic testing allows for the viewing of the NF1 gene, so you can see if it is altered. Genetic testing is easy and only requires a salvia or blood sample.

2) Another possible diagnosis for Kai Rossi is Juvenile Xanthogranuloma. Juvenile Xanthogranuloma is a rare benign skin condition caused by the proliferation of histiocytes. Juvenile xanthogranuloma is common in young children and is characterized by firm yellow, red skin nodules that occasionally effect the eyes. These symptoms are fairly consistent with the bumps and spots in the eyes shown by the patient Kai Rossi. The next step would be to confirm this diagnosis by a biopsy of the bump on the skin. The biopsy would be studied to look for a certain cell prominent in juvenile xanthogranuloma.

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Kai Rossi is a five year old patient who took an MRI scan because of the bumps under his skin on the leg and near the knee. He also has several spots of darker skin on his body, and spots found on his eyes. The MRI scan results revels that the bumps are solid masses not containing fluid.

1) One diagnosis concluded from his symptoms is Neurofibromatosis type 1 known as (NF1) which is a genetic disorder caused by a mutation on chromosome 17. The disorder leads to noncancerous tumors along the nerves which would explain why Kai is energetic and cannot keep still in class. Symptoms of (NF1) are brown patches, soft bumps on or under the skin, and Lisch nodules which is spots in the iris of the eye.

2) The second diagnosis concluded from his symptoms is Tuberous Sclerosis Complex (TSC) which is a genetic disorder caused by mutations in the hamartin or tuberin protein genes causing noncancerous tumors to grow in the brain, eyes, skin, and etc. TSC symptoms are skin abnormalities and behavioral issues like autism or ADHD. Kai's parents mentioned how he has trouble sitting still in school and has trouble focusing which could be because of his possibility of having he has autism or ADHD from TSC. Also the bumps under the skin near the knee relates to the skin abnormalities linking to TSC.

To get further information, Kai would need to get a referral from his doctor to the dermatologist for the patches and bumps on his skin, and an ophthalmologist to get his eyes check out. He would also need to get a biopsy done just to make sure whether his tumor is malignant or benign. He could also get an ultrasound to look at his soft tissues. He should also try to get an EMG to evaluate nerve and muscle function.

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Looking at Kai Rossi's body, the dark patches on him seem to be Café-au-lait macules (CALMs). These spots can show underlying conditions that a person may have. One of these that Kai could have is Neurofibromatosis Type 1 (NF1), a genetic disorder forming noncancerous tumors and creating CALMs on the body and eyes. These, along with the headaches and focus struggles, match up with the diagnosis. Testing would include looking at the biopsy of the suspected tumor and testing genetic background as well. However, another condition could be the bumps being cysts along the underside of the legs. Testing for these cysts could be through ultrasound or a fine-needle aspiration test, where fluid from the bump is extracted and taken to test.

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1. A possible diagnosis could be Neurofibromatosis Type 1 (NF1). Neurofibromatosis Type 1 (NF1) is a genetic disorder that can cause noncancerous/ benign tumors to grow. Key symptoms of NF1 include bumps/spots (neurofibromas), dark spots, eye spots, and behavioral/headaches. An MRI will be needed to determine whether the diagnosis of having NF1 is correct or not. At Kai's visit, he had an MRI taken, which should that these bumps that are under his skin, are masses that do not contain fluid in them. This further proves that these bumps could be a tumor. It is important to then initiate further testing of the bumps to identify the type of tumor. If Kai has NF1, then the test results would identify the tumor as a benign tumor. On top of this, future testing and monitoring of the spots on the eyes and darker skin will be done, as well as watching the growth of these bumps under the skin and throughout the body.

2. Another diagnosis for Kai's unexplained bumps, is cancer, particularly skin cancer. In the case of possibly having skin cancer it is important to undergo an MRI to confirm the suspicion. In this case, Kai Rossi had an MRI scan taken, and by looking at the results, the bumps that appeared on his skin, seem to be masses that do not contain any fluid in them, further solidifying the idea that these bumps could/ are signs of a tumor. More tests are to be done to depict specifically what type of tumor this could be, whether it is benign or malignant. If the further testing and biopsy examinations result in the conclusion of these bumps (tumors) are malignant, then it is important to continue undergoing tests to identify how far in the has tumor spread throughout the body and where it has affected. It is important to keep watch of the bumps, looking at any significant growth, discoloration, size changes, border changes/ irregular borders, and etcetera, as well as the spots on the eyes and the darker skin patches.

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Kai Rossi- 7 year old at Total Care Clinic

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Kai Rossi- 7 year old at Total Care Clinic

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After looking at the results from the tumor biopsied, it was determined that the bumps are benign, so it is not cancerous.

1. The first possible diagnosis for Kai Rossi is Neurofibromatosis Type 1. This is because symptoms occur during childhood, there are brown flat skin spots, spots on the iris, and also has learning disabilities, like ADHD, which is what he has symptoms for. This can also include short stature which includes Kai, because he is 3'7" as the average 7 year old is 4' tall, so on the shorter side of 7 year old boys. There can also be soft non-cancerous tumors under the skin which all describes what Kai has. What I would do to test and see if this diagnosis is correct, is to genetically test the NF1 gene, because this condition is determined by a mutation in the NF1 gene.

2. Another possible diagnosis for Kai is Schwannomatosis. This is a more rare form of Neurofibromatosis, and it is associated with developing multiple benign tumors under the skin. This condition can also cause headaches which is what Kai also has. This is less likely though, because most diagnosed with this, are over 30 years old, although this is still possible with a 7 year old. In order to see if Kai has this, he would need an MRI and genetic testing like the first potential diagnosis.

Both diagnosis' need an MRI and genetic testing to really determine which disease Kai has, if it is one of these. It is more likely that Kai has Neurofibromatosis Type 1 than Schwannomatosis because it aligns more with the symptoms Kai has.

Juanita Blanchard

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1. One possible diagnosis is melanoma. Melanoma is a skin cancer caused by UV radiation and is rather common in young people. Although Kai does not seem to have a family or personal history of melanoma, his MRI results showed that the tumor is a solid mass. The tumor must be biopsied to be certain it is melanoma.

2. Another possible diagnosis for Kai is Neurofibromatosis Type 1 (NF1). NF1 can be defined as a genetic disorder that affects cell growth causing usually begin tumors and skin spots. NF1 can also affect the eyes and nervous system. Kai has brown spots on his body and spots in his eyes. His MRI imaging results also showed his bumps to be solid masses. Genetic testing will be needed to confirm this diagnosis.

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As Kai's bumps are proved to be solid and contain no fluid we can predict he has Neurofibromatosis type one. Particularly this condition causes bumps under the skin and on the eye as experienced by Kai. These symptoms are caused by benign tumors formed due to this condition. In order to confirm our potential diagnosis, we need to run a further biopsy to check for benign tumors, and additional eye exams are useful. Similarly, another condition that Kai might have schwannamatosis which is an altered form of neurofibromatosis where issues in the nerves lead to multiple non cancerous tumor growth that may cause the discoloration and bump found on Kai's skin and eye. Some mechanisms that can be used to test for this condition include high mechanical x-rays that inspect from the brain to the to the spine to spot abnormalities and tumors.

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An MRI showed that Kai Rossi had bumps that do not contain fluid, and the optometrist found spots on his eyes. Additionally, he has constant head aches and struggles with focusing in class. Three potential differential diagnoses could be ADHD, optic pathway glioma and neurofibromatosis type 1.

1. Neurofibromatosis type 1 is likely in Kai because dark spots, pigmented spots, headaches, being hyper and problems focusing are all signs of neurofibromatosis type 1. Following steps I would take for Kai Rossi would be to check for armpit freckling which is a common sign of Neurofibromatosis type 1, and counting the amount of spots that Kai has.

2.ADHD could be present, because Kai has trouble focusing in school and has constant headaches which are signs of ADHD. Also, this is very common in children who have neurofibromatosis type 1. Following steps for this would be to question parents and teachers about Kai's behavior and perform psychological testing for Kai.

3. Another possibility could be optic pathway glioma which is an eye related issue. These vision problems can also create headaches and are often related to neurofibromatosis type 1. Optic pathway glioma is when there is a benign tumor, so I would refer Kai to an ophthalmologist to test for this through an ophthalmology evaluation.

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1. Kai Rossi has a benign tumor on his calf after the MRI we can see that the tumor cells are encased is a specific area and are not affecting the other muscle cells, we should continue to monitor Kai's leg and see if the cancer continues to grow, cause discomfort or turn malignant. Kai Rossi could also have a form of skin cancer as seen with the Figure 1 in the Medical Report we should use the ABCDE to check for if he has a mole that could be cancerous and need to be delt with we should take a biopsy of both of these two to see if they both are or are not cancerous.

2. Kai Rossi could have a form of diabetic retinopathy that causes the spots in his eyes with his family having a history of diabetes he could inherit it causing the spots in his eyes. I would have him perform a glucose test to see weather of not he does have a form of diabetes that causes the spots on his eyes, and I would also want to perform a CBC to see how his blood has been and see if there are any abnormalities in his blood.

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1. Kai could have Keratosis Pilaris which is harmless but it is when the hair follicles are plugged with keratin. The keratin inside the hair follicles is what causes the bumps. Keratosis Pilaris is something that could be passed down so I will order a test on the parents to check if they have any abnormal bumps on their skin.

2. Another diagnosis could be a tumor which is starting to develop. It could be a tumor because the results from the MRI show that the bumps are solid not filled with fluid. This could be tested by taking a blood test and I would also order a biopsy which takes his cells or tissues and examines them. Also, I would order a CT scan to see if there is any irregular masses or tissues near where the bumps are found or on them.

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From the MRI we see that Kai's bumps showed solid masses, not containing fluid. Further testing will clarify if these bumps are benign or malignant. A possible diagnosis for this could be neurofibromatosis NF1. Neurofibromatosis is caused by a genetic disorder, and Neurofibromatosis NF1 can cause skin spots. To test to see if Kai has this I would perform genetic testing.

Another diagnosis could be Xanthelasma. This is when there is flat or slightly raised yellowish patches near the corners of the eyelids. Kai's optometrist shared image of spots found on Kai’s eyes. To test for it, I would order a proper eye examine and get a blood test done because xanthelasma is strongly associated with high cholesterol, a lipid profile.

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Kai Rossi could have a skin cancer based off of his MRI of the bumps on his leg which showed solid masses that contain no fluid. Because a common symptom of solid tumors is bumps on the body, the bumps can be attributed to the tumor. Additionally, malignant tumors can cause skin changes which are seen as the darker spots on Kai's skin. To accurately test the tumor, a biopsy will be needed. If the tumor tissue cells grow quickly, it is malignant. On the other hand, if the cells grow slowly, it is benign.

Kai could also have Seborrheic Keratosis, common, noncancerous clusters of darker spots. These spots are also slightly raised which can correspond to the bumps on Kai's skin. To test for this condition, Kai should go to a dermatologist. The dermatologist will then examine the spots and possibly do a biopsy to identify if he has skin cancer instead.

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1) One diagnosis that could explain the unknown bumps on the back of Kai's knees is Molluscum Contagiosum. Molluscum is a contagious disease that is transmitted through other people that have it. It is usually harmless but if the lesion is scratched or broken, then it will increase the risk of a bacterial infection. Molluscum Contagiosum is most common in kids between the ages of 1 to 10, but it can occur in anyone. To treat this condition, usually it will go away on its own between 6 months to a year but if not, then it can be treated by a dermatologist. In order to test if this is the condition that Kai has, I would plan on having Kai go to a dermatologist to confirm that this is what these bumps are, or I would order a biopsy to confirm that they are either benign or malignant.

2) To explain the dark spots on Kai's back and the greyish brown dots in his eye, Neurofibromatiosis type 1 (NF1) could be an answer. NF1 is a common genetic disorder that causes noncancerous tumors on the nerves, skin discoloration, and developmental disorders. This condition occurs 1 in every 2,500-3,000 kids and symptoms begin to appear around the age of 10. The NF1 gene in the DNA has a mutation that does not allow it to suppress tumor growth as it is supposed to. NF1 is also not a fatal disease however, there is no cure. Treatment mainly includes monitoring the symptoms, taking medications, and/or surgery. To test to see if this is what is causing the dark spots, I would have Kai see a clinical specialist (most likely a geneticist) to confirm that this condition is a genetic disorder.

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1. Neurofibromatosis Type 1 (NF1) is the main differential diagnosis I would give because it matches many of his symptoms of the spots on his skin and on his eyes and in NF1 the solid bumps are almost always present. To test to see if he has it, I would see if NF1 is in his genetics by doing genetic testing and see is the bumps are malignant or not by doing a biopsy.

2. I would say Legius Syndrome is the second choice of diagnosis because it can mimic NF1, but it is a lot milder but doesn't have any cancerous lumps. To test for it I would test for the SPRED1 gene mutation and look at the analysis.

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1. A possible diagnosis could be Neurofibromatosis Type 1. This is supported by the physical evidence evidence of bumps underneath the skin, dark skin spots, and the spots found near the eyes. Other symptoms include headaches and difficulty focusing. To test this diagnosis, I plan to perform genetic testing and a Biopsy of one of the tumors to just confirm the types of cells that may be causing this.

2. Another possible diagnosis could be lipomas. Lipomas are benign fatty tumors under the skin. This maybe could explain for the bumps underneath his knees. To test this I plan on using using imaging such as a Magnetic Resonance Imaging. Performing a biopsy could also help to determine whether the mass is fatty tissue or another type of tumor that we do not know of yet.

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According to the imaging results, Kai's solid bumps appear to be solid and without fluids. A differential diagnosis for this could be that he has hematomas. This can be tested by asking Kai if he gets hurt often when he plays outside with his family and to assess how his bumps look (purple or red discoloration). Another differential diagnosis could be the possibility of having multiple cysts. For the cysts, I would order an ultrasound to understand whether the cyst is showing signs of a benign or cancerous tumor.

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Kai has a benign tumor under his knee, after seeing the results from his scans. The tumor cells are contained within the tumor and arent different from surrounding cells, we can confirm this diagnosis with further testing of the blood and DNA, the dots under his eyes indicate Neurofibromatosis type 1, a skin condition. We can confirm this by taking a genetic blood test.