Hypothalamic Endocrine Tumors: An Update

Round 1

Reviewer 1 Report

This review title “Hypothalamic endocrine tumors: update” is a very interesting article. The authors Asa SL and Mete O have done an exhaustive work. The paper is well written, it is interesting for a wide audience and the bibliography is appropriated.

There is minimal improvement of the manuscript necessary in order to make it acceptable for publication since only de careful editing is necessary. The images must be inserting in the main text after the paragraph of the first citation.

Author Response

We thank the Reviewer for these comments.
We have inserted the figures into the text as recommended.

Reviewer 2 Report

This is a comprehensive review of hypothalamic endocrine tumors.

Lines 28-29. Only some axons go to the posterior lobe.  Others end in the median eminence where hormones are released into the portal vasculature as indicated in the subsequent sentence.  This just needs to be rewritten for clarification. Under clinical manifestations, paragraph 2. Should there be a mention of whether or not bilateral vs. unilateral lesions can cause dysfunction of appetite, temperature, sleep, blood pressure, emotional and breathing dysregulation.  Similarly, I believe such manifestations are only seen with very large lesions?  Should that be discussed? Line 49. Is the significant hyperprolactinemia “…due to excessive stimulation…” or to disinhibition from decreased dopamine.  I think the papers cited to show gangliocytoma production of substances (VIP, enkephalin) causing prolactinoma development are insufficient to really say this happens.  I suggest deleting this phrase.  And also reference to this on line 104. Line 133. Would delete the “low” before “Ki67”  – redundant. Line 137. Please correct the grammar – Neurocytomas present as mass lesions.  Actually, there a many run-on sentences throughout the manuscript.  It bears some editing. I think a table showing which immunohistochemistry markers are present in in which tumors may be helpful.

Author Response

We thank the Reviewer for these important comments.  We have modified the paper as follows:

Lines 28-30. We have added the information about axons terminating in the median eminence with some extending into the posterior lobe Clinical manifestations paragraph 2: We thank the Reviewer for this. We have changed it to “Rarely, involvement and destruction of the various hypothalamic nuclei by extremely large tumors can result in…” to point out the rarity of these extreme manifestations. It is not clear if bilateral involvement is always required so we have omitted this issue. Significant hyperprolactinemia. We agree that this was worded poorly and have deleted the suggestion of excessive stimulation. Thank you for pointing out this error – we have removed the word “low”. We have corrected the grammar as helpfully suggested and split this sentence into two sentences.