Reviewer’s report
Title: 
Esophageal metastasis of renal cell carcinoma resected by endoscopic
submucosal dissection: a case report
Version: 
1 
Date: 
20 May 2021
Reviewer's report:
Ken Ohnita et al submitted this paper entitled "Esophageal metastasis of renal
cell carcinoma resected by endoscopic submucosal dissection: a case report
". The author demonstrated that a growing esophageal polyp that was detected
nine year ago was now found to be renal metastasis and ESD was performed in
this patient. This paper is well written and interesting but I have a few concerns.
Comments: 
1. The author mentioned that the case was asymptomatic on page7 line 106, then
what (any reasons) lead this patient for the endoscopy exam? And what was the
tentative diagnosis (differential diagnosis) upon seeing the lesion during the
endoscopy. These should be mentioned in the article. Author should also
mention about the size of the polyp.
2. The polyp was found nine year ago to be reddish elevated lesion and was
noted to be increased in size within four years (P5 line75 to 76). What were the
diagnosis of endoscopist upon seeing the lesion.(9 years and 4 years ago) Did
they think it was benign therefore it was left with no biopsy or other intervention
(such as ESD)?
3. Did this patient undergo any other surveillance for the metastasis of RCC such
as bone scan or CT? Did the patient have any other metastasis other that the
lesion found in the esophagus?
4. Other than nodular polyp as metastasis of RCC mentioned in this case, any
other endoscopic feature of esophageal metastasis from RCC? Ali S et al have
reported a case of ulcerative esophagitis as metastasis from RCC.(as shown
below) I think readers will be very interested in learning about the features of
metastatic lesion at esophagus from RCC. 
" Not Your Usual Suspect: Clear Cell Renal Cell Carcinoma Presenting as
Ulcerative Esophagitis.
Ali S, Atiquzzaman B, Krall K, Kumar R, Liu B, Hebert-Magee S.
Cureus. 2018 Jun 18;10(6):e2821. doi: 10.7759/cureus.2821."
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration 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 this manuscript, 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 declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
Esophageal metastasis of renal cell carcinoma resected by endoscopic
submucosal dissection: a case report
Version: 
1 
Date: 
20 May 2021
Reviewer's report:
Ken Ohnita et al submitted this paper entitled "Esophageal metastasis of renal
cell carcinoma resected by endoscopic submucosal dissection: a case report
". The author demonstrated that a growing esophageal polyp that was detected
nine year ago was now found to be renal metastasis and ESD was performed in
this patient. This paper is well written and interesting but I have a few concerns.
Comments: 
1. The author mentioned that the case was asymptomatic on page7 line 106, then
what (any reasons) lead this patient for the endoscopy exam? And what was the
tentative diagnosis (differential diagnosis) upon seeing the lesion during the
endoscopy. These should be mentioned in the article. Author should also
mention about the size of the polyp.
2. The polyp was found nine year ago to be reddish elevated lesion and was
noted to be increased in size within four years (P5 line75 to 76). What were the
diagnosis of endoscopist upon seeing the lesion.(9 years and 4 years ago) Did
they think it was benign therefore it was left with no biopsy or other intervention
(such as ESD)?
3. Did this patient undergo any other surveillance for the metastasis of RCC such
as bone scan or CT? Did the patient have any other metastasis other that the
lesion found in the esophagus?
4. Other than nodular polyp as metastasis of RCC mentioned in this case, any
other endoscopic feature of esophageal metastasis from RCC? Ali S et al have
reported a case of ulcerative esophagitis as metastasis from RCC.(as shown
below) I think readers will be very interested in learning about the features of
metastatic lesion at esophagus from RCC. 
" Not Your Usual Suspect: Clear Cell Renal Cell Carcinoma Presenting as
Ulcerative Esophagitis.
Ali S, Atiquzzaman B, Krall K, Kumar R, Liu B, Hebert-Magee S.
Cureus. 2018 Jun 18;10(6):e2821. doi: 10.7759/cureus.2821."
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration 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 this manuscript, 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 declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Esophageal metastasis of renal cell carcinoma resected by endoscopic
submucosal dissection: a case report
Version: 
1 
Date: 
20 May 2021
Reviewer's report:
Ken Ohnita et al submitted this paper entitled "Esophageal metastasis of renal
cell carcinoma resected by endoscopic submucosal dissection: a case report
". The author demonstrated that a growing esophageal polyp that was detected
nine year ago was now found to be renal metastasis and ESD was performed in
this patient. This paper is well written and interesting but I have a few concerns.
Comments: 
1. The author mentioned that the case was asymptomatic on page7 line 106, then
what (any reasons) lead this patient for the endoscopy exam? And what was the
tentative diagnosis (differential diagnosis) upon seeing the lesion during the
endoscopy. These should be mentioned in the article. Author should also
mention about the size of the polyp.
2. The polyp was found nine year ago to be reddish elevated lesion and was
noted to be increased in size within four years (P5 line75 to 76). What were the
diagnosis of endoscopist upon seeing the lesion.(9 years and 4 years ago) Did
they think it was benign therefore it was left with no biopsy or other intervention
(such as ESD)?
3. Did this patient undergo any other surveillance for the metastasis of RCC such
as bone scan or CT? Did the patient have any other metastasis other that the
lesion found in the esophagus?
4. Other than nodular polyp as metastasis of RCC mentioned in this case, any
other endoscopic feature of esophageal metastasis from RCC? Ali S et al have
reported a case of ulcerative esophagitis as metastasis from RCC.(as shown
below) I think readers will be very interested in learning about the features of
metastatic lesion at esophagus from RCC. 
" Not Your Usual Suspect: Clear Cell Renal Cell Carcinoma Presenting as
Ulcerative Esophagitis.
Ali S, Atiquzzaman B, Krall K, Kumar R, Liu B, Hebert-Magee S.
Cureus. 2018 Jun 18;10(6):e2821. doi: 10.7759/cureus.2821."
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration 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 this manuscript, 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 declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
assistant