Medial canthal tophus associated with gout.
OBJECTIVE
To report a case with a gouty tophus at the medial canthus.


METHODS
Observational case report.


METHODS
Review of the clinical, laboratory, photographic, and pathologic records of a patient with a gouty tophus at the medial canthus.


RESULTS
A 27-year-old man had a 3-year history of gouty arthritis and poorly controlled hyperuricemia. A medial canthal mass without discomfort developed gradually over 3 months. An excisional biopsy was performed, and the tissue was fixed in formalin for pathology. Analysis of a routine hematoxylin-and-eosin-stained section disclosed a multilobulated pseudocyst filled with amorphous eosinophilic material. Further staining with nonaqueous alcoholic eosin and viewed under a polarizing microscope indicated the presence of birefringent urate crystals.


CONCLUSIONS
Gouty tophus can develop progressively at the medial canthus, especially in people with uncontrolled hyperuricemia. A formalin-fixed specimen, stained with nonaqueous alcoholic eosin, demonstrates abundant birefringent urate crystals under a polarizing microscope.
Chu
Yen Chang
YC
Department of Ophthalmology, Chang Gung Memorial Hospital, No. 5 Fu-Hsin Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
Hsieh
Yi Yueh
YY
Ma
Lih
L
D000328:Adult; D015210:Arthritis, Gouty / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D001718:Birefringence; D005141:Eyelid Diseases / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid