Review for 10.1186/s12876-020-01552-0 (2020)

Reviewer’s report
Title: 
Extraction of Intra-biliary Hepatocellular Carcinoma by Endoscopic
Retrograde Cholangiopancreatography
Version: 
0 
Date: 
28 Sep 2020
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
RELEVANCE - Does this case report make a contribution to medical
knowledge, have educational value, or highlight the need for a change in clinical
practice or diagnostic/prognostic approaches? 
Yes, this report contributes to medical knowledge
CASE DESCRIPTION - Are the details of the case sufficiently well described to
understand the patient's symptoms and course of treatment? 
No - there are major issues
DIAGNOSIS/INTERPRETATION - Based on the facts presented, are the
diagnosis, interpretation, and course of treatment medically sound?
No, based on information contained in the report, the authors' interpretation of
this case is unsound
DISCUSSION OF THE CASE - Does the discussion appropriately analyse the
importance of the findings and their relevance to future understanding of disease
processes, diagnosis or treatment? Has an adequate literature review pertinent to
the case been included?
Yes, the case is discussed fully in the context of the literature
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED
version of this work represent a technically sound contribution?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: Indeed, it is an interesting case of HCC with biliary
invasion. The final diagnosis was established by tumour samples obtain during
ERCP, which is quite unusual. 
However, there are some comments regarding the management of the case that
should be addressed
REQUESTED REVISIONS: 
It is unusual for HCC to occur in a healthy liver. More details about the
etiological and staging work-up for an eventual underlining liver disease is
needed. 
If the liver was non-cirrhotic, the tumour was relatively small (3 cm) invading
the left biliary duct, why was not treated surgically? The discussion should cover
management dilemmas in these kind of cases.
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