A Case Report of a Rare Dorsal Nasal Gouty Tophus Presenting With a “Hump Nose” Deformity

This report describes an exceptionally rare case of a dorsal nasal gouty tophus presenting as a "hump nose" deformity-an atypical location for tophaceous gout that has been scarcely documented in the literature. A middle-aged male with a long-standing history of gout presented with a progressively enlarging, painless nasal mass over 7 years, which significantly altered his facial profile. Although imaging studies were suggestive of a subcutaneous lesion, definitive diagnosis was achieved only following surgical excision. Histopathological examination confirmed the mass to be a gouty tophus-a deposit of urate crystals eliciting a foreign body reaction. This case highlights the importance of considering gout in the differential diagnosis of atypical facial masses, even in the absence of classic symptoms. It further demonstrates that surgical intervention can serve a dual purpose: providing diagnostic confirmation and successfully restoring both esthetics and function in such unconventional presentations. At 6 month follow-up, the patient remained recurrence-free with an excellent cosmetic outcome.