Reviewer response for version 1
In this case report, the authors offer a clinicopathologic description of a case of pericardial synovial sarcoma.
There are several major points that need to be addressed:
- The patient was treated neoadjuvantly with "high dose" ifosfamide, but the authors describe using 2000 mg/m2 per cycle, which is actually considered quite a low dose for treatment of sarcomas. 
This is either an error (perhaps 2000 mg/m2 was given each day for 3, 4, or 5 days per cycle?) or a very low dose was used intentionally. 
Regardless, the patient apparently benefitted with some tumor shrinkage, which allowed for surgical resection.
- A description of the surgery is lacking. 
We do not know how much pericardium was removed or if lymph nodes were sampled, as sarcomas are known to metastasize lymphatically as well as hematogenously.
- Although postoperative EBRT was administered, there is no discussion about whether intraoperative XRT or proton therapy was considered.
- Upon disease recurrence with a mediastinal mass and pleural effusion, a lobectomy and decortication was performed. 
We are not told if malignant cells were seen in the pleural fluid, in which case the entire pleura would be considered contaminated.
- Post-op, the patient was treated "adjuvantly" with docetaxel. 
Here, the authors need to be careful to point out that single agent docetaxel is not considered standard therapy for synovial sarcoma, and adjuvant therapy after a metastasectomy is also quite a controversial strategy. 
It would be wrong if readers interpreted this report as an endorsement of post-op single agent docetaxel after a metastasectomy.
In summary, it is not clear what we learn from this case report except that the patient apparently sustained a partial tumor response to ifosfamide chemotherapy, tolerated an R1 or R2 surgery, and despite post-op radiation, sustained a regional/metastatic recurrence. 
A more thorough discussion about the complexities and controversies of clinical decision making in patients such as this would make such case reports more informative to the audience.
Structure
Recap
Structure
Weakness
Todo
Recap
Weakness
Weakness
Weakness
Recap
Weakness
Recap
Todo
Other
Weakness
Todo