Diagnosis and Treatment of Langerhans Cell Sarcoma: A Case Report and Review of the Literature

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript describes a rare case of LCS with new insights for its treatment. The manuscript is well written an there are only some minor remarks:

-Line 33: Langerhans cell histiocytose is abbreviated as LCH while in the rest of the manuscript this abbreviations is not used or is replaced by ICL in line 150. The abbreviation LCH should be consistently used and ICL should be avoided.

-Line 63: why was the prostate resected?

-Line 155: what is meant with CL? This abbreviation is unclear.

 

Author Response

This manuscript describes a rare case of LCS with new insights for its treatment. The manuscript is well written an there are only some minor remarks:

-Line 33: Langerhans cell histiocytose is abbreviated as LCH while in the rest of the manuscript this abbreviations is not used or is replaced by ICL in line 150. The abbreviation LCH should be consistently used and ICL should be avoided.

- I have replaced the abbreviation ICL with LCH in all the lines.

-Line 63: why was the prostate resected?

On line 65 I have included the reason for the prostate surgery.

-Line 155: what is meant with CL? This abbreviation is unclear.

I wrote the meaning of the abbreviation at line 19

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

The authors report a rare and interesting case of Langerhans Cells Sarcoma. The paper is well written and informative. Following few minor suggestions.

• In the introduction the flow-cytometry and microscopy parameters to establish diagnosis area described twice.
• Please writ genes’ name in italic (MAP2K1).
• If available, a figure of the histologic exam and bone marrow morphologic examination would enrich the paper.
• Please report CBC count and relevant blood test (including viral screening) findings of the patient at diagnosis.
• NGS detected no high-risk mutations. What about other mutations? For consistency I would report all the findings (if any gene mutation was detected). Furthermore, I’d add also IPSS-M classification.
• If available, I would add the follow-up CT figures.
• KM curves at the end of discussion are informative but it is not really clear where the data come from.

Author Response

The authors report a rare and interesting case of Langerhans Cells Sarcoma. The paper is well written and informative. Following few minor suggestions.

• In the introduction the flow-cytometry and microscopy parameters to establish diagnosis area described twice.

I deleted one of the two descriptions

• Please writ genes’ name in italic (MAP2K1).

I wrote in italic MAP2K1 on line 90 and 24

• If available, a figure of the histologic exam and bone marrow morphologic examination would enrich the paper.

From line 119, I inserted the images of the histological exam with the caption.

• Please report CBC count and relevant blood test (including viral screening) findings of the patient at diagnosis.

I report CBC count and relevant blood test including viral screening on line 70.

• NGS detected no high-risk mutations. What about other mutations? For consistency I would report all the findings (if any gene mutation was detected). Furthermore, I’d add also IPSS-M classification.

The NGS detected only one mutation with a non-significant VAF, but I still calculated and included the molecular M-IPSS on line 103.

• If available, I would add the follow-up CT figures.

On line 130 I add the follow-up CT figures.

• KM curves at the end of discussion are informative but it is not really clear where the data come from.

I add where the data come from on line 204.