Post-Radiation Angiosarcoma (PRA) of the Small Bowel: Report of a Case and Review of the Literature
, Cinzia Baccaro 1, Cuoghi Manuela 1, Adele Fornelli 3, Vincenzo Cennamo 4 and Giuseppe Giovanni Navarra 1Round 1
Reviewer 1 Report
Thanks for the opportunity to review the manuscript ”Post radiation angiosarcoma (PRA) of the small bowel.Report of a case and review of the literature.”. My comments are listed below:
1. My main concern is how the authors can be sure that this is a radion induced angiosarcoma. The patient was earlier treated for a leg cutaneous sarcoma. Isn't it more likely that this is a and metastasis from the previous primary tumor?
2. Were there any other microscopic evidence for radiation damage in resected tissue?
Some improvements needed
Author Response
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Author Response File: 
Author Response.pdf
Reviewer 2 Report
The article presents a rare surgical case with multidisciplinary interest. The clinical case is presented clearly, has beautiful iconography. Bibliographic research adds value to the article. The patient was perfectly surgically managed despite her advanced ageAuthor Response
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Author Response File: Author Response.pdf
Reviewer 3 Report
Thanks for giving me the opportunity to review this manuscript.
Dear Authors,
I read your work with interest.
This work describes a case report of a "iatrogenic" angiosarcoma of the small bowel in a patient previously undergone radiotherapy for pelvis cancer.
The work is interesting, but some issues have been detected and I hope that my suggestions would be appreciated and will be helpful for the Authors.
Line 43-49: I suggest to move this section after line 39, before treating cutaneous AS.
Line 50: does "metastases" refer to cutaneous AS or AS in general? Please, specify.
Line 55-57: use angle quotes, since it is a textual citation.
Line 58-60: a reference is missing. I believe authors can specify what do they mean for "nonspecific", even if for a surgeon they are guessable. This ass would increase the didactic value of the paper.
Case report: the suggested title is only "Case Report" for MDPI journals.
This section is well written but some information are missing: follow up, patient's perspective,, etc). I suggest to add the missing information (where available) according to the CARE Guidelines Checklist (take a look to---> https://www.care-statement.org/checklist ).
I appreciated a lot the images of histopathology. Nevertheless, the pics could be provided for a more detailed description. Even if the main text is equipped, sometimes the reader prefers to skip the entire lecture. Lastly, the level of magnification needs to be reported, since the images shows different ones.
REVIEW OF THE LITERATURE
The Authors offers a mini literature review. The reviewing type is a narrative one, since they defined subjective criteria of work eligibility. The scientific literature accept this methodology, nevertheless you should better specify the type of research you did.
Line 133: key words must be placed in quotation marks (""). You should also specify if you combined them with the Boolean operators. For example: radiation AND bowel, radiation AND bowel AND angiosarcoma, etc. Did you select additional filters? Which temporal period did you consider? Did you evaluate all the work types?
Lastly, since you research is really interesting and potentially useful, I would suggest a sort of scheme/table resuming the main characteristics of small bowel angiosarcoma, a sort of piece of identity/flash card. It would strongly fit with the choose title.
CONCLUSIONS
Please, remore the expression "in conclusion", which is not recommended in all the guidelines.
Picky recommendation: during the entire lecture I was not able to individuate the unicity of the presented case. In other terms: why your case is unusual?
Please, emphasize this concept into the discussion section.
Overall, this work merits to be improved before to be considered for its publication on Surgeries.
Dear Authors, I remain at your disposal for any doubt about my review report.
Good Luck.
Best Regards
Author Response
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Author Response File: Author Response.pdf
Round 2
Reviewer 3 Report
The manuscript has gained its proper improvements.
I do not recognize a real unicity, as stated by the Authors too, but it can be read as a didactic case.
Dear Authors,
Thank you for considering my suggestions and for improving your manuscript.
Lastly, I would only suggest to add proper references in Table 1, to support the exposed contents.
Best Regards
Minor English editing may improve the readability of the manuscript.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
