Footnotes

• Contributors Professor JD suggested the writing up of this case, which describes a long-standing patient of his, as he recognises the rarity of such a case. Professor JD also made many suggestions with the form and focus of the write-up, selected the images when presented to him to be included in the write-up and facilitated the patient completing the consent form. I (Dr Cox) wrote the case study and sourced the images before giving the drafts for review to Professor JD.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None declared.

• Patient consent for publication Obtained.

• Provenance and peer review Not commissioned. Externally peer reviewed by Dominic Paviour, London, UK, and Johann Te Water Naudé, Cardiff, UK.