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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.
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).
EULAR Standing Committee for international clinical studies including therapeutics. EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the Standing Committee for international clinical studies including therapeutics (ESCISIT).
