Review for 10.1186/s12876-021-01964-6 (2021)

Reviewer’s report
Title: 
GIST of the Stomach Masquerading as Recurrent Falls in An Older Adult:
A Case Report and Review
Version: 
0 
Date: 
25 Apr 2021
Reviewer's report:
The authors report a case of occult gastric cancer that presented with atypical
symptoms. Overall, it has the characteristics of rarity and complexity, but there
are major and minor points that the authors may consider. 
First, since the patient's chief complaint were recurrent falls due to intermittent
vertigo. The routine examinations of vertigo, including head CT, MRA,neck
vascular color Doppler ultrasound, EEG and other related auxiliary examinations
should be introduced, to help distinguish whether this vertigo is primary or
secondary.
Then, I have a question. How can we determine that these clinical manifestations
are related to the digestive tract tumor? In fact, asymptomatic upper
gastrointestinal tumors, especially early cancer, are not uncommon. In this case,
the patient can show any symptoms other than those common of digestive
system. 
As is mentioned in the Discussion and Conclusion, the patient has several risk
factors for gastric cancer. So endoscopy is very necessary for her. I think
gastroscopy can be done earlier in this case.
It would be better if there were gastroscopy photos of patients after tumor
resection. This will help us objectively evaluate the treatment effect, not just the
improvement of patients' self symptoms.
The second half of this article is a review of gastric cancer, especially for the
atypical manifestations of elderly patients. The elaboration part of treatment for
gastric cancer is not detailed enough, slightly vague. Consider including the
surgical and endoscopic treatment of curative effect comparison and their
respective superiority and inferiority in this part.
Finally, what is the difference between management of these patients with
atypical symptoms and the other with typical symptoms Please discuss this.
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