Review for 10.1186/s12876-020-01378-w (2020)

Reviewer’ s report
Title: Late stage diagnosis of mucinous adenocarcinoma of the appendix: a case report of an
unusual tumor with a rare presentation
Version: 0Date: 18 Jul 2019
Reviewer's report:
Major:
1)The patient presented with clinical complaints for more than 6 months, with symptomsunderestimated through different medical specialties. With a better structure to the health systemand an early general surgery evaluation it would be very unlikely to end up with such clinicalpresentation. To publish this report may mislead the reader and specially medical professionals tohave the wrong impression of a good care to an unexpected clinical presentation.2)There are information missing about the workup throughout the case: e.g. the first EDassessment was performed by which kind of physician? Why was a surgeon not called at thismoment?3)There are medical concepts wrongly defined in the introduction and discussion. A case report iscited as ref n. 28, and the concept given as the common presentation of the disease. I would alsorecommend the authors to read more about the Garengeot hernia (first described by Rene JaquesCroissant Garengeot in 1731), and specially its difference to the Amyand hernia (described byClaudis Amyand in 1735).4)Last paragraph of page 1 brings wrong oncological concepts of the disease. Ref n. 30 is notappropriate to be referred in this context, and the assumptions are not well done.5)The conclusion is completely disconnected with what was presented. How is this case reporthelping to prevent missing diagnosis? How unique is this case? There are many patients with
recurrent inguinal hernia that may develop severe surgical complications if not treated properly
from the beginning.6)I would recommend an abdominal surgeon supervision to this paper before submitting it againfor publication, as well as an oncological review of the case.
Minor
1)There are many typos mistakes all over the paper, and this exposes the lack of review and careby the authors.2)Topics "image findings" and "subtypes, and pathology affecting patients outcomes" should bemoved to Background session, since they are not related to this specific case at all. After re-writing, the discussion should present literature to address specific questions related to this case.
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 assessAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess 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 furtherassessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
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AcceptableDeclaration of competing interests
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