Lumbar Radiculopathy Secondary to Gouty Tophi in the Filum Terminale in a Patient without Systemic Gout: Case Report

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Abstract
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. The patient presented with typical symptoms of lumbar radiculopathy and neurogenic claudication. There was no evidence of peripheral gout. 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. 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.

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