Gouty tophus: Unusual case of nasal lump

Shiu, Wai Hung Lester; Cheng, Hei Man Joyce; Chan, Yuet Tin; Chu, Chi Yeung; Kan, WK

doi:10.1016/j.radcr.2021.06.094

Radiology Case Reports

2021

DOI: 10.1016/j.radcr.2021.06.094

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Gouty tophus: Unusual case of nasal lump

Wai Hung Lester Shiu

Hei Man Joyce Cheng

Yuet Tin Chan

et al.

Abstract: Chronic tophaceous gout is a common disease but rarely found in the head and neck region. Here we report a case of a middle aged male who presented with a mass over the right side of the nasal bridge. CT of the paranasal sinuses revealed a tophi lesion in the right nasal bridge with erosion of the underlying nasal bone. The mass was excised and histologically confirmed to be a gouty tophus. This case report illustrates how a common disease presented in an uncommon location could pose a diagnostic challenge.

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Cited by 3 publications

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Dermoscopy of nasal and auricular gouty tophi

Santos,

Maciel,

Valente

2024

Anais Brasileiros de Dermatologia

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Dermoscopy of nasal and auricular gouty tophi

Santos,

Maciel,

Valente

2024

Anais Brasileiros de Dermatologia

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Asymptomatic Gouty Tophi in Thyroid Cartilage: A Case Report and Literature Review

Zhen-Li,

De-Dai,

Chen

et al. 2023

Ear Nose Throat J

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Gouty tophi is a disease characterized by the long-term deposition of monosodium urate crystals in joints or cartilages. The most commonly affected site is the first metatarsophalangeal joint, and gouty tophi in the head and neck region are relatively rare. This article reports a case involving an elderly male with asymptomatic gouty tophi in the thyroid cartilage. The patient had a history of gout for over 10 years and presented with a painless thyroid mass that had been present for at least 3 years. He had not received systemic treatment. Preoperative contrast-enhanced cervical CT results indicated a high likelihood of gouty tophi. Postoperative pathology confirmed the mass to be consistent with gouty nodules. Following the procedure, the patient was treated symptomatically with non-busulfan tablets and colchicine. No recurrence was observed at the 1-year follow-up. This report highlights the need to consider gouty tophi in cases of prolonged gout history and abnormal imaging findings in the head and neck region. Appropriate management, including urate-lowering therapy and surgery, if necessary, can lead to optimal outcomes and prevent recurrences. Further research is warranted to enhance understanding and clinical management of this uncommon regional manifestation of gout.

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A Unique Case of Infected Laryngeal Tophi With Underlying Gout

Akashah,

Sanudin,

Malakun

2024

Cureus

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Gout is a disorder of purine metabolism described by the deposition of monosodium urate crystals with rare involvement in the head and neck. This is the first laryngeal gout case reported in Sabah, Malaysia. A 50year-old gentleman with a long history of gouty arthritis presented with acute painless anterior neck swelling for two weeks. An ultrasound of the neck was done, which showed a midline neck mass with intralesional calcification of the cartilaginous component with suspicious erosion of the thyroid cartilage, which was suggestive of thyroid chondroma. However, a computed tomography (CT) scan of the neck showed the fluid collection in the subperichondrium of anterior thyroid cartilage with amorphous calcification, which raised suspicion of infected laryngeal gout. Based on histology and intraoperative findings, laryngeal gout was diagnosed as noted multiple tophy crystals. Microscopic examination confirmed birefringent crystalline deposits. The pathophysiology and management of this rare clinical entity are discussed. We reported this case due to its rarity as well as to increase awareness of laryngeal gout.

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Gouty tophus: Unusual case of nasal lump

Cited by 3 publications

References 6 publications

Dermoscopy of nasal and auricular gouty tophi

Dermoscopy of nasal and auricular gouty tophi

Asymptomatic Gouty Tophi in Thyroid Cartilage: A Case Report and Literature Review

A Unique Case of Infected Laryngeal Tophi With Underlying Gout

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