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Gout is a disorder of purine metabolism characterized by hyperuricemia with rare involvement of the head and neck. We present a 72-year-old woman with a known history of gout who presented with hoarseness and a lesion suspicious for carcinoma of the larynx. Endoscopic biopsy revealed a tophus of the true vocal cord with characteristic birefringent crystalline deposits and giant cell granuloma. There have been limited reports of gouty involvement of the larynx, more commonly involving cricoarytenoid arthritis. Tophi of the laryngeal soft tissues are exceedingly rare. In this paper we will discuss the pathophysiology and management of this interesting clinical entity.

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Granular cell tumors (granular cell myoblastomas) are uncommon neoplasms in the adult population, occurring predominantly in the head and neck and most frequently in the tongue. Laryngeal presentations are unusual, and granular cell tumors of the larynx in children are extremely rare, with a total of 19 cases reported in the literature in children under the age of] 7 years. We report an additional case of a laryngeal granular cell tumor, in a six-year-old boy, and discuss the clinical, histologic, ultrastructural and therapeutic aspects of these neoplasms.