Case-Letter| Volume 351, ISSUE 3, P321-322, March 2016

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Tophaceous Gout in the Nasal Root: An Unusual Initial Presentation

Published:February 21, 2016DOI:
      A 33-year-old man presented with a mass near the left nasal root that had been gradually enlarging for a few years. He had been in good health without any known systemic disease. No significant pain or discoloration was observed on the overlying skin. Bilateral nasal resistance was within the normal limit on rhinomanometry. Head computed tomography (CT) revealed a nodule of approximately 1.4 cm composed of mottled hyperdensities near the left nasal root (Figure A, arrow) eroding the underlying bone (Figure B, arrow). Because of suspicion of a chondroid tumor, hemangioma or other soft tissue tumor, he was admitted to our hospital and received preoperative digital subtraction angiography; however, no tumor blush was observed. Surgical excision of the lesion was performed. Histopathological examination revealed tophaceous gout. The blood test performed after the operation revealed that the serum uric acid concentration (2.1 mg/dL) had decreased.
      Figure thumbnail gr1
      FIGUREA, Axial CT with bone window shows mild erosion and depression of left nasal bone by nodule (arrow). B, Non-contrast enhanced CT shows a well-circumscribed hyperdense nodule near the left nasal root (arrow).
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