Title: Good very informative title but a bit long ;there was no need to mention the patient's age in the title. Abstract: structured well written abstract,but some of the information can be omitted as it is already mentioned else where in the abstract references: 45 references is definitely too much for a case report ideally should not be more than ten ,so I would advice cutting them down.

introduction/background Very informative yet length introduction good for an article but really long for a case report,22 reference in introduction is too much,I would suggest cutting them down . Language is good no grammatical errors noted

methodology As this was a case report there was not much methodology involved ,but the case itself was very well presented yet again some of the irrelevant details could have been cut down. Written in good English with no grammatical or punctuation errors

data and results Data and facts were clearly and nicely presented in a timely fashion,all relevant information were mentioned ,references included when needed. No grammatical errors noted

Discussion structured well presented discussion in good ,clear language,no obvious plagiarism noted,yet it is a bit lengthy for a case report. Good balance of clinical,histological as well as radiological data included

conclusions Clear conclusion highlighting the importance of the presented case also stratifying management plan for this specific condition.