Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1373
Peer-review started: August 23, 2021
First decision: October 22, 2021
Revised: October 30, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: February 6, 2022
Processing time: 153 Days and 18.7 Hours
Gouty tophus is rarely reported in the head and neck areas. To the best of our knowledge, this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid (SUA) levels.
We report a case of multiple gouty tophi in the nasal dorsal and auricle regions with normal SUA levels. The patient was admitted to the hospital with a chief complaint of recurrent nasal swelling and pain for 3 years, which was aggravated for 3 d. The patient’s SUA level had been regularly reviewed in the outpatient department and had been successfully controlled for several years. Resection of the nasal masses was performed. Cartilage from the right ear cavity was used to repair the nasal defects. The pathological report confirmed a nasal gouty tophus. No recurrence or deformity was found after a 1 year follow-up.
Normal SUA cannot completely negate the diagnosis of gouty tophus, especially in some rare regions.
Core Tip: Hyperuricemia is a key factor in the formation of gouty tophus, and it is often detected on the first metatarsophalangeal or first metacarpophalangeal joints of both hands. It is rarely reported in the head and neck areas, such as the throat and auricle. We believe that clinicians should be aware of the possibility of gouty tophus in patients with a history of gout, especially in some rare regions. For surgeons, an accurate preoperative diagnosis can help determine the appropriate operation mode and incision size.