Lumbar radiculopathy secondary to gouty tophi in the filum terminale in a patient without systemic gout: Case report

OBJECTIVE AND IMPORTANCE: Gouty arthritis and gouty tophi of the spine are very rare. We present a patient with the clinical manifestations of an intradural tumor and histologically proven gouty deposits in the filum terminale. CLINICAL PRESENTATION: The patient presented with typical symptoms of lumbar radiculopathy and neurogenic claudication. There was no evidence of peripheral gout. INTERVENTION: Imaging studies, including computed tomography and magnetic resonance imaging, demonstrated a 1-cm, round, intradural, calcified lesion at the L3 vertebral level, causing moderate spinal stenosis. The patient underwent a two-level laminectomy and removal of the mass. A pathological examination of the specimen revealed gouty deposits in the region of the filum terminale. CONCLUSION: Spinal involvement in gout is very rare, and intradural gouty deposits have not been previously described. Intradural gout should be considered in the differential diagnosis of intradural masses.