Massive Gouty Tophi Presenting as Pseudotumor of the Elbow: A Rare Presentation

Divesh Jalan; Deepak Kumar Maley; Abhay Elhence; Poonam Elhence; Princi Jain

doi:10.7759/cureus.6769

Massive Gouty Tophi Presenting as Pseudotumor of the Elbow: A Rare Presentation

Cureus. 2020 Jan 25;12(1):e6769. doi: 10.7759/cureus.6769.

Authors

Divesh Jalan¹, Deepak Kumar Maley², Abhay Elhence³, Poonam Elhence⁴, Princi Jain⁵

Affiliations

¹ Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
² Orthopaedics, MediCiti Institute of Medical Sciences, Hyderabad, IND.
³ Orthopaedics, All India Institute of Medical Sciences, Jodhpur, IND.
⁴ Pathology, All India Institute of Medical Sciences, Jodhpur, IND.
⁵ Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi, IND.

Abstract

Gout is a systemic metabolic disorder characterized by hyperuricemia and deposition of monosodium urate crystals in joints and other extra-articular tissues. Poorly controlled cases progress to chronic gout with tophi, which can sometimes assume massive sizes. We report one such case of a 39-year-old male with poorly controlled polyarticular tophaceous gout presenting with a massive swelling of the left elbow simulating a soft tissue tumor. Subsequent investigations confirmed it to be a massive tophus which was then surgically excised, as the mass was not responding to the medical management. At the latest follow-up after two years, the patient has full function of the elbow and gout is well controlled with medications.

Keywords: arthritis; gout; pseudotumor; tophi.

Publication types

Case Reports