Giant gouty liquid tophus occurring in both lower legs: One rare case report
10.3760/cma.j.cn311282-20240425-00168
- VernacularTitle:罕见双侧小腿巨大液态痛风石一例报道
- Author:
Zibing SONG
1
;
Duoduo LIU
;
Tingting SHEN
;
Congrong WANG
Author Information
1. 南方医科大学南方医院增城院区检验医学科，广州 511358
- Keywords:
Tophus;
Giant tophus;
Liquid tophus;
Monosodium urate
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(9):789-792
- CountryChina
- Language:Chinese
-
Abstract:
A case of giant liquid tophus in both lower legs was reported. The patient was a 41-year-old man with a history of gout for more than 10 years. The patient had hyperlipidemia and prediabetes, and the long-term use of hormone cortisol drugs was suspected. After standardized treatment for lowering uric acid, reducing blood lipids, and correcting glucose intolerance, the patient lost 12 kg over six months. The patient was admitted to the hospital upon discovering symmetrical enlargement of both calves. Ultrasound showed subcutaneous masses with clear boundaries behind the gastrocnemius muscle, approximately 14.9 cm×6.7 cm on the left and 13.6 cm×4.6 cm on the right. Based on the clinical information and morphological features, a diagnosis of gouty tophus was made. Following ultrasound-guided puncture drainage, aspirate about 200 mL fluid from the subcutaneous masses of each lower legs. The patient continued to receive standardized uric acid-lowering treatment and the patient′s condition improved. For such atypical giant liquid tophus, clinical practitioners should remain vigilant, differentiating them from tumors, infections, autoimmune diseases, and promptly perform pathological examinations through puncture to be diagnosed. After a definitive diagnosis, surgical excision can be performed concurrently with standardized uric acid-lowering treatment to achieve a favorable prognosis.
