Reviewer’s report
Title: 
Postmenopausal hyperandrogenism due to an ovarian sex cord-stromal
tumour causing elevated Dehydroepiandrosterone sulfate; a case report
Version: 
1 
Date: 
06 May 2022
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 minor issues
DIAGNOSIS/INTERPRETATION - Based on the facts presented, are the
diagnosis, interpretation, and course of treatment medically sound?
Yes, the work described is medically sound
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?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: This is an interesting case report of Postmenopausal
hyperandrogenism due to an ovarian sex cord-stromal tumour
causing elevated Dehydroepiandrosterone sulfate. Some additional descriptions
of the intraoperative findings and pathologic features of the tumour would
strengthen the paper.
This is a novel case as elevated DHEAS originating from an ovarian neoplasm is
unusual as reported here
REQUESTED REVISIONS: 
Please provide additional information as listed below :
-Besides hyperandrogenism, any symptoms of abdominal pain, pressure, bowel
or bladder disturbances? I would expect some symptoms as the ovarian mass was
quite large up to the umbilicus.
-Please describe intraoperative findings in more details. Was there upper
abdominal or nodal disease? Was washing done? Adhesions to other organs?
rupture? friability? abnormalities of other organs like adrenal?
-Please describe pathology in more details: tumour grade? LVSI?tumour on
surface?
-Why was pelvic radiotherapy used instead of chemotherapy?
ADDITIONAL REQUESTS/SUGGESTIONS: 
As listed above, additional information will strengthen the quality of the paper
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