ArticleJournal of medical case reports2025
Kiesselbach's area nasal septal gouty tophus with an integrated "3 + 2" diagnostic algorithm: a case report.
Article in Journal of medical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGout, characterized by monosodium urate crystal deposition, rarely involves the nasal septum, with only a few reported cases. Such unusual presentations can mimic other conditions, necessitating prompt and accurate diagnosis. This report describes a rare case of gouty tophus in Kiesselbach's area of the anterior nasal septum. CASE PRESENTATION: A 59 year-old Han Chinese man with a 20/year history of gout, off urate-lowering therapy, presented with painless external nasal swelling. Imaging, including computed tomography (110-220 Hounsfield units calcified nodule) and dual-energy computed tomography (confirmed monosodium urate deposition), combined with histopathology, validated tophaceous gout. He underwent open surgical excision and received postoperative urate-lowering therapy, achieving no recurrence at 9 months with serum urate < 300 μmol/l.
conclusionThis case highlights the importance of considering gouty tophus in atypical nasal masses, especially in patients with gout history. Dual-energy computed tomography is a valuable diagnostic tool. We propose a practical "3 + 2" diagnostic algorithm to aid early recognition, although further validation in larger series is needed.
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