Reviewer’ s report
Title: Late stage diagnosis of mucinous adenocarcinoma of the appendix: a case report of an
unusual tumor with a rare presentation
Version: 0Date: 02 Sep 2019
Reviewer: JD Coyne
Reviewer's report:
This is an interesting paper and could be published. It does require significant modification.
The title should be changed to something resembling " Mucinous adenocarcinoma of theappendix: a case report of an unusual tumour with a rare presentation".In the background section I suggest that the rarity of the condition is specifically put in contextwith other appendiceal neoplasms. The use of the statement " it has a higher probability to burstand cause pseudomyoxoma " should be omitted because the presence of extraappendiceal mucinwith mucinous epithelium confers that association. The symptoms and presentation betweenfemale and male patients differ if the ovaries and scrotum can be involved.The case presentation is too long and most of the information is not relevant. For example it is notpertinent to reference the patients blood pressure, height, the history of the patients father andother details. Moreover, it is not necessary to state the type of declined chemotherapy. I suggestthat this section be reduced to a minimum.The diagnosis receives minimal comment and there is no histological image. Was there no inputfrom a surgical pathologist?In the discussion the second and sixth sentence are repetitive. The seventh and eight relateidentical information. The imaging section is nebulous. The onion skin appearance of a mucocoele
is discussed twice although the paper is about a different pathology. Discussion of it should be
confined to its relevancy to this case.In the subtypes section, brief mention of low grade mucinous neoplasms is merited but it would bemore appropriately discussed with the differential diagnosis. The majority of the information hereis quotes a small number of random references. Why not simply state that the prognosis is worseand quote a single reference. The authors suggest that the patients combination of symptoms mayindicate a diagnosis of appendiceal neoplasm/mucinous adenocarcinoma is hypothetical. This isfollowed by more irrelevant nonspecific imaging information.The section under the title of strengths and limitations should be deleted.The English needs to be amended throughout this case report.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively editedDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I have no competing interestsI agree to the open peer review policy of the journal. I understand that my name will be included
on my report to the authors and, if the manuscript is accepted for publication, my named report
including any attachments I upload will be posted on the website along with the authors'
responses. I agree for my report to be made available under an Open Access Creative CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich I do not wish to be included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’ s report
Title: Late stage diagnosis of mucinous adenocarcinoma of the appendix: a case report of an
unusual tumor with a rare presentation
Version: 0Date: 02 Sep 2019
Reviewer: JD Coyne
Reviewer's report:
This is an interesting paper and could be published. It does require significant modification.
The title should be changed to something resembling " Mucinous adenocarcinoma of theappendix: a case report of an unusual tumour with a rare presentation".In the background section I suggest that the rarity of the condition is specifically put in contextwith other appendiceal neoplasms. The use of the statement " it has a higher probability to burstand cause pseudomyoxoma " should be omitted because the presence of extraappendiceal mucinwith mucinous epithelium confers that association. The symptoms and presentation betweenfemale and male patients differ if the ovaries and scrotum can be involved.The case presentation is too long and most of the information is not relevant. For example it is notpertinent to reference the patients blood pressure, height, the history of the patients father andother details. Moreover, it is not necessary to state the type of declined chemotherapy. I suggestthat this section be reduced to a minimum.The diagnosis receives minimal comment and there is no histological image. Was there no inputfrom a surgical pathologist?In the discussion the second and sixth sentence are repetitive. The seventh and eight relateidentical information. The imaging section is nebulous. The onion skin appearance of a mucocoele
is discussed twice although the paper is about a different pathology. Discussion of it should be
confined to its relevancy to this case.In the subtypes section, brief mention of low grade mucinous neoplasms is merited but it would bemore appropriately discussed with the differential diagnosis. The majority of the information hereis quotes a small number of random references. Why not simply state that the prognosis is worseand quote a single reference. The authors suggest that the patients combination of symptoms mayindicate a diagnosis of appendiceal neoplasm/mucinous adenocarcinoma is hypothetical. This isfollowed by more irrelevant nonspecific imaging information.The section under the title of strengths and limitations should be deleted.The English needs to be amended throughout this case report.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively editedDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I have no competing interestsI agree to the open peer review policy of the journal. I understand that my name will be included
on my report to the authors and, if the manuscript is accepted for publication, my named report
including any attachments I upload will be posted on the website along with the authors'
responses. I agree for my report to be made available under an Open Access Creative CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich I do not wish to be included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’ s report
Title: Late stage diagnosis of mucinous adenocarcinoma of the appendix: a case report of an
unusual tumor with a rare presentation
Version: 0Date: 02 Sep 2019
Reviewer: JD Coyne
Reviewer's report:
This is an interesting paper and could be published. It does require significant modification.
The title should be changed to something resembling " Mucinous adenocarcinoma of theappendix: a case report of an unusual tumour with a rare presentation".In the background section I suggest that the rarity of the condition is specifically put in contextwith other appendiceal neoplasms. The use of the statement " it has a higher probability to burstand cause pseudomyoxoma " should be omitted because the presence of extraappendiceal mucinwith mucinous epithelium confers that association. The symptoms and presentation betweenfemale and male patients differ if the ovaries and scrotum can be involved.The case presentation is too long and most of the information is not relevant. For example it is notpertinent to reference the patients blood pressure, height, the history of the patients father andother details. Moreover, it is not necessary to state the type of declined chemotherapy. I suggestthat this section be reduced to a minimum.The diagnosis receives minimal comment and there is no histological image. Was there no inputfrom a surgical pathologist?In the discussion the second and sixth sentence are repetitive. The seventh and eight relateidentical information. The imaging section is nebulous. The onion skin appearance of a mucocoele
is discussed twice although the paper is about a different pathology. Discussion of it should be
confined to its relevancy to this case.In the subtypes section, brief mention of low grade mucinous neoplasms is merited but it would bemore appropriately discussed with the differential diagnosis. The majority of the information hereis quotes a small number of random references. Why not simply state that the prognosis is worseand quote a single reference. The authors suggest that the patients combination of symptoms mayindicate a diagnosis of appendiceal neoplasm/mucinous adenocarcinoma is hypothetical. This isfollowed by more irrelevant nonspecific imaging information.The section under the title of strengths and limitations should be deleted.The English needs to be amended throughout this case report.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively editedDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I have no competing interestsI agree to the open peer review policy of the journal. I understand that my name will be included
on my report to the authors and, if the manuscript is accepted for publication, my named report
including any attachments I upload will be posted on the website along with the authors'
responses. I agree for my report to be made available under an Open Access Creative CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich I do not wish to be included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant