Recurrence or de novo? Intradermal Basal Cell Carcinoma of the Scrotum: A Report of Two Cases
Round 1
Reviewer 1 Report
I thank the academic editor for the opportunity to review this interesting manuscript. It is a paper presenting two cases (81 and 73 respectively) of basal cell carcinoma (BCC) of the scrotal skin, starting from the fact that the literature would seem to indicate a greater aggressiveness for this location of BCC. The presentation is well structured with very clear morphological and immunohistochemical (Berp4) images. The discussion section is complete.
In this interesting paper, the authors report two cases of Basal Cell Carcinoma (BCC) in scrotal skin. In doing so they present a thorough introduction (which, in my opinion, could be implemented with more attention to the differential diagnosis with cutaneous adnexal neoplasms), a good clinical and histopathological description of the two cases of scrotal BCC, emphasising the point that while in case one the lesion was entirely intradermal, in case two (previously biopsied and excised) it could be reasonable to infer that it was a change from nodular BCC to micronodular BCC. In the Discussion section, the authors present more accepted theories to explain the genesis of BCC.
Major Points:
- please, change part of the title as stating 'case report of two cases' is cacophonous.
- In Introduction section I suggest to discuss briefly the other differential diagnosis of BCC, such as adnexal neoplasms
Minor points:
Line 15: please, add a “-“ to the word “reexamined”.
please insert a space before a parenthesis.
Line 63-64: please rephrase it because is misleading.
Figure 1: please, add a black outline to the image as in image 1B.
Figure 1(AB) caption: please, not use many parenthesis because it is confusing.
Line 158: it’s not necessary the comma within the parenthesis.
1) Checking of some typos;
2) linguistic revision.
Author Response
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Author Response File: 
Author Response.docx
Reviewer 2 Report
BCC is the most common skin cancer nonmelanocitic and histologic variant micronodular is the most aggressive. Localization in the genitalia is rare.Did you find some risk factor as chronic eczema, immunodepression or something else?I think that rugosity of the scrotum makes the borders of tumour difficult to be detected and wider and deeper excision should be recommended to prevent recurrence. What does mean nodular type be complicated with micronodular? a transformation? The teory discussed is suggestive, but in my opinion doesn't explain the case 2 where the recurrence should be explained with the incomplete removal of previous tumour already micronodular
Author Response
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Author Response File: Author Response.docx
Reviewer 3 Report
The authors reported an interesting case about a BCC of the scrotum. Some minor changes are needed.
-In the discussion the authors should better speculate about the pathogenesis of BCC of the scrotum, highlighitng how BCC (compared to SCC) cannot be associated with sun exposure.
- In the Discussion a little paragraph with the main clinical, dermosocpic and pathological differential diagnoses should be performed by the authors. Higlighting which are the most common tumors (both benign and malignant) that can arise in the scrotum.
- Please add also a parapgraph about the main clinical, dermoscopic and histologic features of aggressive subtypes of basal cell carcinoma.
- Please add also a Table with a review of the literature regarding the cases of BCC of the scrotum reported so far. You can add in the table the following parameters: Article (reporteding the first author), year of publication, number of cases, gender, treatment, any recurrence.
Thank you
Author Response
Please see the attachment.
Author Response File: Author Response.docx
