Silent Expansion of a Rare Temporal Bone Mass: Skull Base Gout Tophus-Case Report and Review of the Literature

Skull base gout tophus is an exceptionally rare entity, with only a handful of cases reported in the literature. We present the case of an 81-year-old male with a large temporal skull base mass causing intracranial mass effect and involving the infratemporal fossa and mandible. Remarkably, the patient was minimally symptomatic, with the only notable history being progressive enlargement of the mass over 6–12 months accompanied by dull discomfort, without associated neurological deficits. Operative incisional biopsy revealed findings consistent with a gout tophus and calcium deposition. Importantly, the patient had no prior history of gout. He was referred to rheumatology for further evaluation and initiation of medical management, which remains ongoing at the time of this report. Although skull base tophaceous gout is exceedingly uncommon, it should be considered in the differential diagnosis of expansile temporal bone mass lesions. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany