Reviewer's report 
 A case of sigmoid endometriosis difficult to differentiate from colon cancer Title: 
Authors: 
Philippos Dimoulios ( fdimoul@hotmail.com )
Dr Ioannis E Koutroubakis ( ktjohn@her.forthnet.gr )
Maria Tzardi ( tzardi_maria@yahoo.uk )
Dr Pavlos Antoniou ( pantoniou_gr@yahoo.com )
Ioannis M Matalliotakis ( matalliotakis@hotmail.com )
Prof Elias A Kouroumalis ( kouroum@med.uoc.gr )
 1  3 Jun 2003 Version: Date: 
 Jerome B. B Simon Reviewer: 
 A paper of limited interest Level of interest: 
 Accept after discretionary revisions Advice on publication: 
This is a well-written, succinct case report pointing out that intestinal involvement with endometriosis 
can simulate other disorders including colorectal malignancy. This point has broad interest for family 
physicians, gynecologists, gastroenterologists, and surgeons. However, this lesson is already 
well-documented in the literature, and the present report merely serves as a reminder without adding 
any new information or presenting a unique aspect of the problem. Nevertheless it is worth 
reiterating this often-overlooked message. 
DISCRETIONARY REVISIONS 
1. The argument that the patient's endometriosis mimicked cancer would be strengthened by 
including a photo of the "filling defect and an extrinsic bowel compression" on barium enema (P.4) 
2. An endoscopic photo of the "extensive polypoid lesion" at colonoscopy (P.4) would also be 
valuable if available. 
3. What is meant by the statement that the initial histology "was not diagnostic" (P.4, L.14)? What 
did the biopsies actually show? 
4. The statement that MRI is the most sensitive imaging technique for intestinal endometriosis 
should be referenced (P.6, L.9). 
5. On P.6, L.19 the authors state that the CT and barium enema findings helped direct the diagnosis 
of endometriosis -- yet earlier they claim the opposite, that these investigations initially suggested 
malignancy and that the diagnosis became clear only after the biopsies from the second colonoscopy. Which was it? 
6. Figure 2 is redundant; one photomicrograph of the endometriosis is sufficient. 
7. The text is lucid, but a few minor errors of spelling and syntax need correction (e.g. a redundant 
"the" in the second line of the Abstract; "dispareunia" on P.5, L.18; "become" instead of "be" on P.6, 
L.8). 
Competing interests: 
None declared. 
Reviewer's report 
 A case of sigmoid endometriosis difficult to differentiate from colon cancer Title: 
Authors: 
Philippos Dimoulios ( fdimoul@hotmail.com )
Dr Ioannis E Koutroubakis ( ktjohn@her.forthnet.gr )
Maria Tzardi ( tzardi_maria@yahoo.uk )
Dr Pavlos Antoniou ( pantoniou_gr@yahoo.com )
Ioannis M Matalliotakis ( matalliotakis@hotmail.com )
Prof Elias A Kouroumalis ( kouroum@med.uoc.gr )
 1  3 Jun 2003 Version: Date: 
 Jerome B. B Simon Reviewer: 
 A paper of limited interest Level of interest: 
 Accept after discretionary revisions Advice on publication: 
This is a well-written, succinct case report pointing out that intestinal involvement with endometriosis 
can simulate other disorders including colorectal malignancy. This point has broad interest for family 
physicians, gynecologists, gastroenterologists, and surgeons. However, this lesson is already 
well-documented in the literature, and the present report merely serves as a reminder without adding 
any new information or presenting a unique aspect of the problem. Nevertheless it is worth 
reiterating this often-overlooked message. 
DISCRETIONARY REVISIONS 
1. The argument that the patient's endometriosis mimicked cancer would be strengthened by 
including a photo of the "filling defect and an extrinsic bowel compression" on barium enema (P.4) 
2. An endoscopic photo of the "extensive polypoid lesion" at colonoscopy (P.4) would also be 
valuable if available. 
3. What is meant by the statement that the initial histology "was not diagnostic" (P.4, L.14)? What 
did the biopsies actually show? 
4. The statement that MRI is the most sensitive imaging technique for intestinal endometriosis 
should be referenced (P.6, L.9). 
5. On P.6, L.19 the authors state that the CT and barium enema findings helped direct the diagnosis 
of endometriosis -- yet earlier they claim the opposite, that these investigations initially suggested 
malignancy and that the diagnosis became clear only after the biopsies from the second colonoscopy. Which was it? 
6. Figure 2 is redundant; one photomicrograph of the endometriosis is sufficient. 
7. The text is lucid, but a few minor errors of spelling and syntax need correction (e.g. a redundant 
"the" in the second line of the Abstract; "dispareunia" on P.5, L.18; "become" instead of "be" on P.6, 
L.8). 
Competing interests: 
None declared. 
Please review this paper.
user
Reviewer's report 
 A case of sigmoid endometriosis difficult to differentiate from colon cancer Title: 
Authors: 
Philippos Dimoulios ( fdimoul@hotmail.com )
Dr Ioannis E Koutroubakis ( ktjohn@her.forthnet.gr )
Maria Tzardi ( tzardi_maria@yahoo.uk )
Dr Pavlos Antoniou ( pantoniou_gr@yahoo.com )
Ioannis M Matalliotakis ( matalliotakis@hotmail.com )
Prof Elias A Kouroumalis ( kouroum@med.uoc.gr )
 1  3 Jun 2003 Version: Date: 
 Jerome B. B Simon Reviewer: 
 A paper of limited interest Level of interest: 
 Accept after discretionary revisions Advice on publication: 
This is a well-written, succinct case report pointing out that intestinal involvement with endometriosis 
can simulate other disorders including colorectal malignancy. This point has broad interest for family 
physicians, gynecologists, gastroenterologists, and surgeons. However, this lesson is already 
well-documented in the literature, and the present report merely serves as a reminder without adding 
any new information or presenting a unique aspect of the problem. Nevertheless it is worth 
reiterating this often-overlooked message. 
DISCRETIONARY REVISIONS 
1. The argument that the patient's endometriosis mimicked cancer would be strengthened by 
including a photo of the "filling defect and an extrinsic bowel compression" on barium enema (P.4) 
2. An endoscopic photo of the "extensive polypoid lesion" at colonoscopy (P.4) would also be 
valuable if available. 
3. What is meant by the statement that the initial histology "was not diagnostic" (P.4, L.14)? What 
did the biopsies actually show? 
4. The statement that MRI is the most sensitive imaging technique for intestinal endometriosis 
should be referenced (P.6, L.9). 
5. On P.6, L.19 the authors state that the CT and barium enema findings helped direct the diagnosis 
of endometriosis -- yet earlier they claim the opposite, that these investigations initially suggested 
malignancy and that the diagnosis became clear only after the biopsies from the second colonoscopy. Which was it? 
6. Figure 2 is redundant; one photomicrograph of the endometriosis is sufficient. 
7. The text is lucid, but a few minor errors of spelling and syntax need correction (e.g. a redundant 
"the" in the second line of the Abstract; "dispareunia" on P.5, L.18; "become" instead of "be" on P.6, 
L.8). 
Competing interests: 
None declared. 
assistant