Tophaceous Gout Misidentified as Inflammatory Polyp in External Auditory Canal

Abstract

Gout is an inflammatory disorder in which urate crystals are deposited in the joints or soft tissues causing severe inflammation and pain. Urate crystals usually deposit in the joints, and sometimes in the extra-articular sites. A 67-year-old woman visited the otolaryngology clinic due to otalgia and discharge from the ear. She had experienced recurrent arthritis in the left second metatarsophalangeal joint from five years ago. She visited the otolaryngology clinic of our university hospital due to persistent inflammation in the ear canal despite treatment with antibiotics. An otoscopic examination showed a polyp-like mass near the eardrum. Computed tomography scan of temporal bone showed thickening of the eardrum and increased soft tissue density in the external ear canal. On histologic examination the polyp was finally found to be a urate crystal mass. She is now in a good state with urate lowering therapy. We report on a Korean case of tophaceous gout in the external ear canal that was misidentified as an inflammatory polyp.