Reviewer’s report
Title: 
Multiple non-polypoid mucosal Schwann cell hamartomas presenting as
edematous and submucosal tumor-like lesions: a case report
Version: 
0 
Date: 
05 Dec 2020
Reviewer's report:
Dear authors,
Congratulation on this interesting and very intriguing case that you report.
I think it is represents a valuable addition to the, as you state, scarce literature on
MSCH.
However, there are some issues that I would like for you to address:
-The terminology you use could be clearer. For the vanishing lesion, the term
"sub-epithelial lesion" would be more suitable since it we have no evidence from
which layer of the bowel wall it raised from (please check the ASGE guideline
on subepithelial lesions on the GI tract). 
-Line 37: would add the characteristic "single", like it appears on the abstract
-Line 43: in the seminal work by Gibson, "intramucosal perineuromas" and
"mucosal benign epithelioid nerve sheath tumor" are included in the differential
diagnosis. Why did you choose not to include those lesions?
-Line 44: would make a more complete description of the MSCH, including the
missing features: entrapment of colonic crypts, poorly circumscribed; dense
eosinophilic cytoplasm
-Line 46: although mostly negative, some MSCH may stain for NFP, revealing
rare axons. Would correct this
-Line 49: multiple MSCH reference is missing: "[2,7]"
-Line 58: in which colonic segment was the lesion? That is very important and
should be made clear
-Line 62: you mention the pharmacological class in the treatment of hypertension
and diabetes, but then the specific drug to AF. This should be coherent (say the
specific drug to HTA/DM or refer to dabigaran as a NOAC)
-Line 73: specify the colonic segments from which the additional lesions were
resected
-Line 74: was the diagnosis of hyperplasic nodule based on the
chromoendoscopy, biopsy or resection?
-Line 81: would make a more detailed description about the presence of
inflammatory cells (mononuclear vs polymorphonuclear; density;
distribution…). They are not mentioned on other case reports on MSCH. Does
their presence compromise the diagnosis? Would made a comment on that.
-Line 103: would not use "asymptomatic" since a substantial part of individuals
who undergo screening colonoscopy may have mild GI symptoms, even though
they are not the indication for the examination. 
-Line 119: please confirm your references. Reference 8: small whitish nodules; I
cannot find the other two lesions in reference 1 or 8
Table 1: eliminate the term "asymptomatic" and substitute for "screening" or
"non-diagnostic colonoscopy" for the reasons mentioned above. In study [1], two
cases had "unkown" indication/symptom for colonoscopy, however there is no
"unkwown" line in this table. Please correct
About the figures, they would benefit from arrows/arrow heads and
corresponding legend so that the reader can identify the lesions more easily. If
you could get a higher definition image of the histologic pictures that would be
great.
Publons Reviewer Recognition
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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 
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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 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 
do not
 publish my name
with my report. (default)
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: 
Multiple non-polypoid mucosal Schwann cell hamartomas presenting as
edematous and submucosal tumor-like lesions: a case report
Version: 
0 
Date: 
05 Dec 2020
Reviewer's report:
Dear authors,
Congratulation on this interesting and very intriguing case that you report.
I think it is represents a valuable addition to the, as you state, scarce literature on
MSCH.
However, there are some issues that I would like for you to address:
-The terminology you use could be clearer. For the vanishing lesion, the term
"sub-epithelial lesion" would be more suitable since it we have no evidence from
which layer of the bowel wall it raised from (please check the ASGE guideline
on subepithelial lesions on the GI tract). 
-Line 37: would add the characteristic "single", like it appears on the abstract
-Line 43: in the seminal work by Gibson, "intramucosal perineuromas" and
"mucosal benign epithelioid nerve sheath tumor" are included in the differential
diagnosis. Why did you choose not to include those lesions?
-Line 44: would make a more complete description of the MSCH, including the
missing features: entrapment of colonic crypts, poorly circumscribed; dense
eosinophilic cytoplasm
-Line 46: although mostly negative, some MSCH may stain for NFP, revealing
rare axons. Would correct this
-Line 49: multiple MSCH reference is missing: "[2,7]"
-Line 58: in which colonic segment was the lesion? That is very important and
should be made clear
-Line 62: you mention the pharmacological class in the treatment of hypertension
and diabetes, but then the specific drug to AF. This should be coherent (say the
specific drug to HTA/DM or refer to dabigaran as a NOAC)
-Line 73: specify the colonic segments from which the additional lesions were
resected
-Line 74: was the diagnosis of hyperplasic nodule based on the
chromoendoscopy, biopsy or resection?
-Line 81: would make a more detailed description about the presence of
inflammatory cells (mononuclear vs polymorphonuclear; density;
distribution…). They are not mentioned on other case reports on MSCH. Does
their presence compromise the diagnosis? Would made a comment on that.
-Line 103: would not use "asymptomatic" since a substantial part of individuals
who undergo screening colonoscopy may have mild GI symptoms, even though
they are not the indication for the examination. 
-Line 119: please confirm your references. Reference 8: small whitish nodules; I
cannot find the other two lesions in reference 1 or 8
Table 1: eliminate the term "asymptomatic" and substitute for "screening" or
"non-diagnostic colonoscopy" for the reasons mentioned above. In study [1], two
cases had "unkown" indication/symptom for colonoscopy, however there is no
"unkwown" line in this table. Please correct
About the figures, they would benefit from arrows/arrow heads and
corresponding legend so that the reader can identify the lesions more easily. If
you could get a higher definition image of the histologic pictures that would be
great.
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 upon publication of the manuscript. 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 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 
do not
 publish my name
with my report. (default)
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: 
Multiple non-polypoid mucosal Schwann cell hamartomas presenting as
edematous and submucosal tumor-like lesions: a case report
Version: 
0 
Date: 
05 Dec 2020
Reviewer's report:
Dear authors,
Congratulation on this interesting and very intriguing case that you report.
I think it is represents a valuable addition to the, as you state, scarce literature on
MSCH.
However, there are some issues that I would like for you to address:
-The terminology you use could be clearer. For the vanishing lesion, the term
"sub-epithelial lesion" would be more suitable since it we have no evidence from
which layer of the bowel wall it raised from (please check the ASGE guideline
on subepithelial lesions on the GI tract). 
-Line 37: would add the characteristic "single", like it appears on the abstract
-Line 43: in the seminal work by Gibson, "intramucosal perineuromas" and
"mucosal benign epithelioid nerve sheath tumor" are included in the differential
diagnosis. Why did you choose not to include those lesions?
-Line 44: would make a more complete description of the MSCH, including the
missing features: entrapment of colonic crypts, poorly circumscribed; dense
eosinophilic cytoplasm
-Line 46: although mostly negative, some MSCH may stain for NFP, revealing
rare axons. Would correct this
-Line 49: multiple MSCH reference is missing: "[2,7]"
-Line 58: in which colonic segment was the lesion? That is very important and
should be made clear
-Line 62: you mention the pharmacological class in the treatment of hypertension
and diabetes, but then the specific drug to AF. This should be coherent (say the
specific drug to HTA/DM or refer to dabigaran as a NOAC)
-Line 73: specify the colonic segments from which the additional lesions were
resected
-Line 74: was the diagnosis of hyperplasic nodule based on the
chromoendoscopy, biopsy or resection?
-Line 81: would make a more detailed description about the presence of
inflammatory cells (mononuclear vs polymorphonuclear; density;
distribution…). They are not mentioned on other case reports on MSCH. Does
their presence compromise the diagnosis? Would made a comment on that.
-Line 103: would not use "asymptomatic" since a substantial part of individuals
who undergo screening colonoscopy may have mild GI symptoms, even though
they are not the indication for the examination. 
-Line 119: please confirm your references. Reference 8: small whitish nodules; I
cannot find the other two lesions in reference 1 or 8
Table 1: eliminate the term "asymptomatic" and substitute for "screening" or
"non-diagnostic colonoscopy" for the reasons mentioned above. In study [1], two
cases had "unkown" indication/symptom for colonoscopy, however there is no
"unkwown" line in this table. Please correct
About the figures, they would benefit from arrows/arrow heads and
corresponding legend so that the reader can identify the lesions more easily. If
you could get a higher definition image of the histologic pictures that would be
great.
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 upon publication of the manuscript. 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 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 
do not
 publish my name
with my report. (default)
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