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1 The authors provide data of three In this article we have described 3 unusual
patients that could be summarized as a cases and not one single case. Three cases
cannot be summarized as a case-report,
case report.
hence case-series is more appropriate
nomenclature as used in this article.
The three patients clearly presented with The authors agree with the reviewers
evidence of malignant neoplasm. In the comment. Hence the article includes the key
first and last cases, ultrasonography was
message “There is a definite need of
performed followed by contrast enhanced
CT scan. The second patient was accurate and early diagnosis of such
unfortunately first operated on and only cases by the ultrasonography or CT scan
afterwards underwent a CT scan that to manage such cases optimally by early
revealed multiple retroperitoneal masses appropriate medical treatment.”
compatible with malignancy.
2 The authors do not provide patients’ CBC Case 1: When evaluated, he was found to
or blood chemistry that could be have hemoglobin of 9 gm/dL. His serum
indicative of a lymphoid malignancy. This LDH value was 526 U/L.
is essential, since usually, the lactic
dehydrogenase (LDH) level is very high
in patients with Burkitt lymphoma.
Case 2: On evaluation, he was found to
have hemoglobin of 10 gm/dL, serum
bilirubin of 1.4 mg/dL, uric acid of 8
mg/dL and LDH of 593 U/L.
Case 3: On evaluation, he was found to
have hemoglobin of 9.5 gm/dL, uric acid
of 7.8 mg/dL and LDH of 624 U/L.
There is a nice summary emphasizing Following text has been included
that sporadic Burkitt lymphoma usually in main article: We recommend
presents with an abdominal mass, similar that before subjecting a patient
to the three evaluated cases. The take- with abdominal mass with
home massage should be the deranged hematological
requirement of performing CE/CT prior to parameters and raised LDH to
any surgical intervention to identify the surgical exploration, a thorough
main etiology. Blood chemistry and CBC CECT abdomen should be done
are mandatory and LDH levels should be to rule out lymphoreticular
evaluated. An interventional radiologist malignancy. Interventional
should be consulted in order to find out if radiologist can be of great help in
through-cut biopsy or less extensive providing guided biopsies from
interventional biopsy could be performed inaccessible sites for
in such a suspicious case. These histopathological confrmation
measures could save a prolonged and subtyping, which may help
recovery and enable a rapid initiation of institute early chemotherapy
therapy in Burkitt lymphoma. without providing surgical
morbidity in selected cases.
