Song Y, Kang ZW, Liu Y. Multiple gouty tophi in the head and neck with normal serum uric acid: A case report and review of literatures. World J Clin Cases 2022; 10(4): 1373-1380 [PMID: 35211572 DOI: 10.12998/wjcc.v10.i4.1373]
Corresponding Author of This Article
Yan Liu, Doctor, MM, Surgeon, Department of Otorhinolaryngology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian 116000, Liaoning Province, China. dyyyliuyan@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2022; 10(4): 1373-1380 Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1373
Multiple gouty tophi in the head and neck with normal serum uric acid: A case report and review of literatures
Yang Song, Zi-Wei Kang, Yan Liu
Yang Song, Zi-Wei Kang, Yan Liu, Department of Otorhinolaryngology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
Author contributions: Song Y contributed to the original draft and visualization; Kang ZW contributed to the collection of case data; Liu Y contributed to the conceptualization, original draft and visualization; all authors have read and approved the manuscript.
Informed consent statement: The study protocol was approved by the ethics committee of The First Affiliated Hospital of Dalian Medical University. All participants in the present analysis gave written informed consent before they participated in this study.
Conflict-of-interest statement: Yang Song, Zi-Wei Kang, and Yan Liu declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Liu, Doctor, MM, Surgeon, Department of Otorhinolaryngology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian 116000, Liaoning Province, China. dyyyliuyan@163.com
Received: August 23, 2021 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
