Reviewer's report
Title:Gastrinoma and neurofibromatosis type 2: the first case report and review
of the literature.
Version:2Date:15 November 2013
Reviewer: Antongiulio Faggiano
Reviewer's report:
Massironi et al. reported about an unusual association between NF2 and
gastrin-secreting PNET. Although the report is original some concerns limits the
comprehension of the article and its scientific value.
Major points
1) the main concern is about the lack of a histo/citological diagnosis of NET. The
pathological demonstration of malignant cell and thier neuroendocrine nature is
mandatory to conclude that the nodule within the pancreas is a PNET.The
authors need to provide information about.
2) the authors conclude that the case in object is a gastrinoma on the basis of the
association between peptic ulcer anf hypergastrinemia. However, to demonstrate
an increased gastric acid outout (pH <2) is necessary to achieve the biochemical
diagnosis of ZES. Authors should provide this information. Furthermore, all
possible causes of hypergastrinemia have to be carefully excluded, not only
HP-positive gastritis (please see ENETS guideline, Neuroendocrinology
2012;95:98)
3) Finally, how long did you stop PPI before serum gastrin assessment? This
point is crucial, because a week at least is required after PPI withdrawal
4) Secretin test was not necessary in this case due the really high levels of
serum gastrin and once again it could not replace the assessment of pH which is
at opposite diagnostic
5) Due to the rare comination of different type of tumor a MEN1-like phenotype is
consistent and therefore, a genetic test for the CDKN1B gene is required. Please
provide information
Minor point
1) page 6, galliumPET, which type of somatostatin analogue? please detail
2) Figure 1, replace gastrin with serum gastrin levels
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Reviewer's report
Title:Gastrinoma and neurofibromatosis type 2: the first case report and review
of the literature.
Version:2Date:15 November 2013
Reviewer: Antongiulio Faggiano
Reviewer's report:
Massironi et al. reported about an unusual association between NF2 and
gastrin-secreting PNET. Although the report is original some concerns limits the
comprehension of the article and its scientific value.
Major points
1) the main concern is about the lack of a histo/citological diagnosis of NET. The
pathological demonstration of malignant cell and thier neuroendocrine nature is
mandatory to conclude that the nodule within the pancreas is a PNET.The
authors need to provide information about.
2) the authors conclude that the case in object is a gastrinoma on the basis of the
association between peptic ulcer anf hypergastrinemia. However, to demonstrate
an increased gastric acid outout (pH <2) is necessary to achieve the biochemical
diagnosis of ZES. Authors should provide this information. Furthermore, all
possible causes of hypergastrinemia have to be carefully excluded, not only
HP-positive gastritis (please see ENETS guideline, Neuroendocrinology
2012;95:98)
3) Finally, how long did you stop PPI before serum gastrin assessment? This
point is crucial, because a week at least is required after PPI withdrawal
4) Secretin test was not necessary in this case due the really high levels of
serum gastrin and once again it could not replace the assessment of pH which is
at opposite diagnostic
5) Due to the rare comination of different type of tumor a MEN1-like phenotype is
consistent and therefore, a genetic test for the CDKN1B gene is required. Please
provide information
Minor point
1) page 6, galliumPET, which type of somatostatin analogue? please detail
2) Figure 1, replace gastrin with serum gastrin levels
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Please review this paper.
user
Reviewer's report
Title:Gastrinoma and neurofibromatosis type 2: the first case report and review
of the literature.
Version:2Date:15 November 2013
Reviewer: Antongiulio Faggiano
Reviewer's report:
Massironi et al. reported about an unusual association between NF2 and
gastrin-secreting PNET. Although the report is original some concerns limits the
comprehension of the article and its scientific value.
Major points
1) the main concern is about the lack of a histo/citological diagnosis of NET. The
pathological demonstration of malignant cell and thier neuroendocrine nature is
mandatory to conclude that the nodule within the pancreas is a PNET.The
authors need to provide information about.
2) the authors conclude that the case in object is a gastrinoma on the basis of the
association between peptic ulcer anf hypergastrinemia. However, to demonstrate
an increased gastric acid outout (pH <2) is necessary to achieve the biochemical
diagnosis of ZES. Authors should provide this information. Furthermore, all
possible causes of hypergastrinemia have to be carefully excluded, not only
HP-positive gastritis (please see ENETS guideline, Neuroendocrinology
2012;95:98)
3) Finally, how long did you stop PPI before serum gastrin assessment? This
point is crucial, because a week at least is required after PPI withdrawal
4) Secretin test was not necessary in this case due the really high levels of
serum gastrin and once again it could not replace the assessment of pH which is
at opposite diagnostic
5) Due to the rare comination of different type of tumor a MEN1-like phenotype is
consistent and therefore, a genetic test for the CDKN1B gene is required. Please
provide information
Minor point
1) page 6, galliumPET, which type of somatostatin analogue? please detail
2) Figure 1, replace gastrin with serum gastrin levels
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
assistant