Endocrine Mucin-Producing Sweat Gland Carcinoma: Case Presentation with a Comprehensive Review of the Literature
, Emilio Bellitti 2, Irma Trilli 3, Anna Colagrande 1, Nicoletta Sgarro 1, Vincenza Sara Scarcella 1, Teresa Lettini 1, Giuseppe Ingravallo 1, Domenico Piscitelli 1, Leonardo Resta 1 and Lucia Lospalluti 4Round 1
Reviewer 1 Report
The authors while describing a new case of endocrine mucin-producing sweat gland cacinoma made a comprehensive review of the literature. No new data are available from this manuscript. However, we are dealing with a rare entity. The mainstay of diagnosis relies on immunohistochemistry with positivity of neuroendocrine markers. Moreover, there is a recent systemic review of this tumor with metanalysis (Ref.53).
-There is a recent systematic review and metanalysis of this tumor that the authors cited (Ref.53 Froehlich et al, 2022) with a discrepancy of data compared to this paper. The authors should make a comment.
-The authors should comment about differential diagnoses with other sweat gland cutaneous tumors
-Immmunostaining with p63 or calponin or SMA could be added for highlighting the myoepithelial layer around the dermal nodules. Also CK 20 could be added to rule out a metastatic carcinoma of colorectum
English could be improved
Author Response
Reviewer n’1: There is a recent systematic review and metanalysis of this tumor that the authors cited (Ref.53 Froehlich et al, 2022) with a discrepancy of data compared to this paper. The authors should make a comment.
Answer n’1: Dear Reviewer n’1, first of all thank you very much for your precious comments to our manuscript. So, we have checked with great attention our manuscript and the manuscript cited in 53’ reference. we found only 4 items of difference from the paper. Of these, Chang et al [2010] was added because we decided to include the search on Google Scholar as well. We continued to eliminate Rutten et al [2014] as it was written in German and not in line with our inclusion criteria (English language); we added Turnbull [2015] and Chen [2018] as we also included cases with EMPSGC component of a primary mucinous carcinoma of the skin. Therefore, we have updated the whole paper.
Reviewer n‘1: -The authors should comment about differential diagnoses with other sweat gland cutaneous tumors
Answer n’2: Dear Reviewer n’1,
thank you very much for this advice. We have included two sentences that clarify and emphasize the main differential diagnoses of EMPSGC with other primary cutaneous adnexal lesions.
Reviewer n’1: -Immmunostaining with p63 or calponin or SMA could be added for highlighting the myoepithelial layer around the dermal nodules. Also CK 20 could be added to rule out a metastatic carcinoma of colorectum.
Answer n’3: Thanks a lot for these suggestions. So, we had some problems with further immunostaining because the samples is finished and there isn’t possibility to perform others reaction. Sorry for this one.
Reviewer 2 Report
My statement "accept in present form" is based on the specific format of the manuscript and its content: the authors provide a solitary case (!) of a malignant sweat gland carcinoma [EMPSGC] which they describe in a detailed, concise, and complete way, including all “state of the art” light microscopic and immunohistochemical methods. I could not find any flaws with this casuistic presentation, and therefore suggest that the present manuscrpt is accepted as it is. The main part of the present manuscript, however, is a detailed and complete, 26-year-spanning review of the present literature on this rare cutaneous sweat gland carcinoma. The authors cite – both in a table and in an accompanying discussion format – all published papers on that particular entity. Their compilation is concise, complet, and well-structured. Again, I find now flaws with that presentation. I consider it both complete and sufficient for the readership of the journal. Admittedly, clinical photographs and a slightly more detailed data set within the table (eg clinical follow-up and clinical outcome) would add helpful information, albeit more on the basis of “wishful thinking” than well-balanced reviewer criticism.Author Response
Reviewer n’2: My statement "accept in present form" is based on the specific format of the manuscript and its content: the authors provide a solitary case (!) of a malignant sweat gland carcinoma [EMPSGC] which they describe in a detailed, concise, and complete way, including all “state of the art” light microscopic and immunohistochemical methods. I could not find any flaws with this casuistic presentation, and therefore suggest that the present manuscript is accepted as it is. The main part of the present manuscript, however, is a detailed and complete, 26-year-spanning review of the present literature on this rare cutaneous sweat gland carcinoma. The authors cite – both in a table and in an accompanying discussion format – all published papers on that particular entity. Their compilation is concise, complete, and well-structured. Again, I find now flaws with that presentation. I consider it both complete and sufficient for the readership of the journal. Admittedly, clinical photographs and a slightly more detailed data set within the table (eg clinical follow-up and clinical outcome) would add helpful information, albeit more on the basis of “wishful thinking” than well-balanced reviewer criticism.
Answer n’1: Dear Reviewer n’2, thank you so much for your beautiful words that moved us so much. We always try to do our best with humility, scientific and intellectual honesty and a sense of duty. Kind regards.
The authors
Reviewer 3 Report
This is an excellent article describing a case report of endocrine mucin-producing sweat gland carcinoma (EMPSGC) followed by a comprehensive literature review. The article is generally well written, although careful English grammar and spelling check should be undertaken to correct minor mistakes, for example:
- "elides" should be corrected to "eyelids"
- "inclusion epidermal cyst" would be more correct as "epidermal inclusion cyst" or "epidermoid cyst".
The large table provided is comprehensive and I think it should be kept.
However, I think that an extra more succint table would be useful to summarize the most important points about this neoplasm. In particular, follow-up information would be very informative in order to confirm its low-grade malignant potential. So, it would be good to include the follow-up period of the cases reported so far, as well as the main outcomes (percentage of recurrence and metastasis).
The article is generally well written, although careful English grammar and spelling check should be undertaken to correct minor mistakes, for example:
- "elides" should be corrected to "eyelids"
- "inclusion epidermal cyst" would be more correct as "epidermal inclusion cyst" or "epidermoid cyst".
Author Response
Reviewer n’3: This is an excellent article describing a case report of endocrine mucin-producing sweat gland carcinoma (EMPSGC) followed by a comprehensive literature review. The article is generally well written, although careful English grammar and spelling check should be undertaken to correct minor mistakes, for example:
- "elides" should be corrected to "eyelids"
- "inclusion epidermal cyst" would be more correct as "epidermal inclusion cyst" or "epidermoid cyst".
The large table provided is comprehensive and I think it should be kept.
Answer n’1: Dear Reviewer n’3, thank you very much for your wonderful words. So, we have checked and corrected the mistakes. Thanks a lot.
Reviewer n’3: However, I think that an extra more succint table would be useful to summarize the most important points about this neoplasm. In particular, follow-up information would be very informative in order to confirm its low-grade malignant potential. So, it would be good to include the follow-up period of the cases reported so far, as well as the main outcomes (percentage of recurrence and metastasis).
Answer n’2: Dear Reviewer, thanks so much for your suggestion. We have added a table (table 2) with all informations that you ask us. We hope that now paper is ready.
A warm greeting
Round 2
Reviewer 1 Report
More or less all the queries have been answered
Minor editing
