Title: Primary yolk sac tumor of the endometrium combined with situs inversus totalis: A case
report and literature review
Version: 5 Date: 26 Jul 2024
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?
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?
No - there are major issues
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: I read carefully the manuscript "Primary yolk sac tumor of the
endometrium combined with situs inversus totalis: A case report and literature review".
Although I acknowledge that this case report in interesting, it needs substantial changes to be
improved. For the sake of clarity, I declare that I did not review the previous version of the
manuscript.
REQUESTED REVISIONS:
I recommend to take into account the following suggestions:
- A round of language revision by a native speaker would be needed to improve grammar and
style. For example, "tumors such as embryonal carcinoma or dysgerminoma , the cases with
ovarian surface epithelial tumors have been seen in elderly patients" could be clearer. Ensure all
sentences are complete and avoid run-on sentences.
- Introduction: The section could benefit from clearer and more logical flow. Currently, it jumps
between topics without clear transitions. Some parts of the text lack cohesion. For example, the
transition from discussing YST to SIT could be smoother. Explain the relevance of SIT to the
case being discussed more clearly.
- Introduction: Consider splitting longer sentences to improve readability.
- Introduction: Ensure consistent use of terminology. For instance, "YST" should be used
consistently after its first introduction.
- Introduction: Provide more context or explanation for some statements, such as how the
differentiation into yolk sacs occurs.
- Introduction: Reference all key points, especially specific claims about the incidence of SIT
and its relationship with tumors.
- Introduction: Ensure that acronyms are spelled out fully the first time they are used, such as
SIT (Situs Inversus Totalis).
- Introduction: Provide more specific details where necessary. For example, when discussing
the age range or specific statistics, ensure that these are clearly stated and referenced.
- Introduction: The introduction of the case study could be more engaging and informative.
Provide a brief summary of the case upfront to capture interest.
- Case presentation: The section provides a detailed account of the case but could benefit from
improved structure and flow. Ensure a logical progression of information from patient history
to diagnosis, treatment, and follow-up.
- Case presentation: The section provides a detailed account of the case but could benefit from
improved structure and flow. Ensure a logical progression of information from patient history
to diagnosis, treatment, and follow-up.
- Case presentation: Use consistent terminology throughout. For example, avoid switching
between "mass" and "tumor" unless distinguishing between different findings.
- Case presentation: Provide specific details where necessary. For example, specify the
significance of the normal levels of other tumor markers.
- Case presentation: Explain the relevance of the serum AFP level and its fluctuations during
treatment.
- Case presentation: The patient’s medical history should be presented more clearly. Separate
past medical history from current symptoms and findings.
- Case presentation: Provide more details on the chemotherapy regimen and its rationale. Explain
why the PEP regimen was chosen and how it works.
- Case presentation: The follow-up period should be clearly stated and any ongoing monitoring
should be described. Mention any future follow-up plans if applicable.
- Discussion: This section needs to be reduced in length. Some sentences are long and complex.
Break them into shorter, clearer sentences. Eliminate repetitive phrases and ensure each sentence
adds new information.
- Discussion: Clearly introduce the key findings from the literature search and how they relate
to your case.
- Discussion: Ensure consistency in tense usage. For instance, switch to past tense when
discussing the patient's case and findings.
- Discussion: Provide a more detailed explanation of the hypotheses mentioned.
- Discussion: Discuss the possible link between SIT and YST more thoroughly, referencing
specific studies and data where applicable.
- Discussion: Compare and contrast your case with the cases found in the literature. Highlight
what makes your case unique.
- Discussion: Discuss the diagnostic challenges in more detail, including the differential
diagnosis and the importance of specific diagnostic markers like AFP.
- Discussion: Provide more detail on why the PEP regimen was chosen and how it compares to
the BEP regimen. Discuss the rationale for using pingyangmycin instead of bleomycin.
- Discussion: Expand on the discussion of surgical options and the decision-making process for
preserving ovarian function in young women.
- Discussion: Elaborate on the factors that affect prognosis, including the stage of the disease
and response to treatment.
- Discussion: Emphasize the importance of long-term follow-up and the role of serum AFP in
monitoring for recurrence.
- Discussion: Clearly summarize the key points of the discussion, highlighting the significance
of the case and the insights gained.
- Discussion: Suggest areas for future research and the need for more data on rare cases like
YST with SIT.