Reviewer ’s report  
 
Title:  Hepatic metastatic paraganglioma 12 years after retroperitoneal paraganglioma resection: 
a case report  
 
Version: 0 Date: 21 Jun 2019 
 
Reviewer:  Marco  Carbone  
 
Reviewer’s report:  
 
Zhao -Ru Dong and coauthors report a unique case of liver metastasis from retroperitoneal 
paraganglioma or chemodectoma.  
 
The case is interesting as it show the slow progression of the metastatic disease. However it is 
poorly detailed and it is  not clear the final message.  
 
> Authors are invited to provide more details on the initial history of retroperitoneal resection 
and staging of disease as well as histology assessment; on the size of the liver tumor when found 
at their centre; on the respo nse (that they define failed) to TACE and explain the decision process 
that took to stop the follow -up; how they approached the anaemia, likely related to the tumour 
(did they excluded other causes of microcytic anaemia? she s a lady in fertile age who mig ht 
easily be anemic from period); and what was the decision process after the liver biopsy and 
imaging review, apart from the fact that the patient refused any treatment; what was the rate of 
progression of the tumour per year? Have they performed a tumour  extra liver staging?  
 
> What can the reader learn from this case? Do we need to just observe as you suggest? or it 
might be worth to be aggressive in such big lesions in a 39 years old lady considering that, even 
slowly, the tumour grows?  
 
> English revi ew from a professional writer is strongly suggested.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does 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.  
 
Yes 
Are you able to as sess 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 manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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.  
 
I 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 repo rt to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my nam ed report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  Hepatic metastatic paraganglioma 12 years after retroperitoneal paraganglioma resection: 
a case report  
 
Version: 0 Date: 21 Jun 2019 
 
Reviewer:  Marco  Carbone  
 
Reviewer’s report:  
 
Zhao -Ru Dong and coauthors report a unique case of liver metastasis from retroperitoneal 
paraganglioma or chemodectoma.  
 
The case is interesting as it show the slow progression of the metastatic disease. However it is 
poorly detailed and it is  not clear the final message.  
 
> Authors are invited to provide more details on the initial history of retroperitoneal resection 
and staging of disease as well as histology assessment; on the size of the liver tumor when found 
at their centre; on the respo nse (that they define failed) to TACE and explain the decision process 
that took to stop the follow -up; how they approached the anaemia, likely related to the tumour 
(did they excluded other causes of microcytic anaemia? she s a lady in fertile age who mig ht 
easily be anemic from period); and what was the decision process after the liver biopsy and 
imaging review, apart from the fact that the patient refused any treatment; what was the rate of 
progression of the tumour per year? Have they performed a tumour  extra liver staging?  
 
> What can the reader learn from this case? Do we need to just observe as you suggest? or it 
might be worth to be aggressive in such big lesions in a 39 years old lady considering that, even 
slowly, the tumour grows?  
 
> English revi ew from a professional writer is strongly suggested.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does 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.  
 
Yes 
Are you able to as sess 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 manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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.  
 
I 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 repo rt to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my nam ed report can be included as confidential comments 
to 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:  Hepatic metastatic paraganglioma 12 years after retroperitoneal paraganglioma resection: 
a case report  
 
Version: 0 Date: 21 Jun 2019 
 
Reviewer:  Marco  Carbone  
 
Reviewer’s report:  
 
Zhao -Ru Dong and coauthors report a unique case of liver metastasis from retroperitoneal 
paraganglioma or chemodectoma.  
 
The case is interesting as it show the slow progression of the metastatic disease. However it is 
poorly detailed and it is  not clear the final message.  
 
> Authors are invited to provide more details on the initial history of retroperitoneal resection 
and staging of disease as well as histology assessment; on the size of the liver tumor when found 
at their centre; on the respo nse (that they define failed) to TACE and explain the decision process 
that took to stop the follow -up; how they approached the anaemia, likely related to the tumour 
(did they excluded other causes of microcytic anaemia? she s a lady in fertile age who mig ht 
easily be anemic from period); and what was the decision process after the liver biopsy and 
imaging review, apart from the fact that the patient refused any treatment; what was the rate of 
progression of the tumour per year? Have they performed a tumour  extra liver staging?  
 
> What can the reader learn from this case? Do we need to just observe as you suggest? or it 
might be worth to be aggressive in such big lesions in a 39 years old lady considering that, even 
slowly, the tumour grows?  
 
> English revi ew from a professional writer is strongly suggested.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does 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.  
 
Yes 
Are you able to as sess 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 manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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.  
 
I 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 repo rt to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my nam ed report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant