Title: MRI and FDG PET/CT Findings for Small cell neuroendocrine carcinoma of the Ovary:
A Case Report and Literature Review
Version: 0 Date: 12 Oct 2024
Reviewer:  Roghieh Nooripour
Reviewer's report:
Based on my review, I would recommend opting for MAJOR REVISIONS.
Abstract
1. Enhance the structure by clearly delineating background, methods, results, and conclusions.
2. Provide more specific details about the imaging findings, particularly the unique aspects of
MRI and FDG-PET/CT results.
3. Clarify the significance of the elevated NSE levels in relation to the diagnosis of OSCNEC.
4. Strengthen the conclusion by emphasizing the key takeaways and potential clinical
implications of this case report.
5. Revise for conciseness while ensuring all critical information is retained.
Background
1. Expand on the epidemiology of OSCNEC to provide context for its rarity.
2. Clarify the distinction between OSCNEC and SCCOHT more explicitly, including their
genetic and clinical differences.
3. Provide a brief overview of the typical presentation and prognosis of OSCNEC to set the
stage for the case report.
4. Elaborate on the challenges in diagnosing OSCNEC and why detailed imaging findings are
crucial.
5. Strengthen the rationale for reporting this case by highlighting the gaps in current literature
regarding imaging findings of OSCNEC.
Case presentation
1. Reorganize the presentation of clinical, laboratory, and imaging findings for better flow and
clarity.
2. Provide more detailed descriptions of the MRI sequences used and their specific parameters.
3. Elaborate on the PET/CT findings, including a more thorough description of the distribution
and intensity of FDG uptake in various lesions.
4. Include a brief description of the differential diagnoses considered based on the imaging
findings prior to histological confirmation.
5. Provide more details about the surgical procedure, including any intraoperative findings that
contributed to staging or diagnosis.
6. Expand on the histopathological findings, including the specific immunohistochemical
staining results and their significance in differentiating OSCNEC from other entities.
Review of the Literature
1. Provide a more comprehensive and systematic approach to the literature review, including the
search strategy, inclusion/exclusion criteria, and the total number of relevant studies identified.
2. Present a more detailed analysis of the existing literature, including a synthesis of the key
findings from previous case reports and studies.
3. Create a more comprehensive table summarizing the imaging findings from previous reports,
including both similarities and differences with the current case.
4. Discuss any trends or patterns observed in the literature regarding the presentation, diagnosis,
and outcomes of OSCNEC cases.
5. Highlight the gaps in the current literature that this case report addresses, particularly
regarding imaging findings and the use of FDG-PET/CT.
Discussion and Conclusions
1. Provide a more in-depth discussion of how the imaging findings in this case compare to those
of other ovarian malignancies and small cell carcinomas of other origins.
2. Elaborate on the potential role of FDG-PET/CT in the diagnosis and staging of OSCNEC,
discussing its advantages and limitations.
3. Discuss the clinical implications of the findings, particularly the importance of considering
OSCNEC in the differential diagnosis of ovarian masses with certain imaging characteristics
and elevated NSE levels.
4. Address the limitations of this single case report and suggest areas for future research to
further characterize the imaging features of OSCNEC.
5. Strengthen the conclusion by providing clear, actionable insights for clinicians and
radiologists encountering similar cases in the future.