Wu Huiqing, Klein Michael J, Stahl Rosalyn E, Sanchez Miguel A
Department of Pathology, Mount Sinai School of Medicine, New York, NY, USA.
Hum Pathol. 2004 Jul;35(7):897-9. doi: 10.1016/j.humpath.2004.04.003.
A 37-year-old black woman with nephritis secondary to systemic lupus erythematosus, steroid-induced diabetes mellitus, and hypertension presented with fever, nausea, vomiting, and right upper quadrant abdominal pain with distension. Abdominal computed tomography (CT) scan revealed a colonic mass, and CT- guided fine-needle aspiration demonstrated birefringent crystalline material. After several weeks of antibiotic therapy, the patient underwent laparoscopic examination followed by extended right hemicolectomy for a large mass in the subserosa of the transverse colon. Pathological examination of this mass revealed it to be a gouty tophus. To our knowledge, no case of tophaceous gout presenting as an intestinal mass has previously been reported.