Tophaceous gout in the lumbar spinal canal mimicking epidural spinal tumor in a male adolescent: A case report.

RATIONALE: Spinal gout is a rare occurrence, with varied symptoms based on the location of urate deposits, and diagnosis is typically delayed. Herein, we present a unique case of juvenile lumbar spinal gout.

PATIENT CONCERNS: A 16-year-old male patient was admitted to our hospital because of lower back pain for 11 days. histopathological evaluation identified gouty tophus in the lumbar spinal.

DIAGNOSES: This patient was diagnosed with Tophaceous gout in the lumbar spinal.

INTERVENTIONS: Following laboratory and imaging assessment, the patient underwent surgery, and histopathological evaluation identified gouty tophus. Post surgery, the patient experienced a gradual improvement in symptoms, and he recovered well without any complications.

OUTCOMES: During follow-up, the patient's serum uric acid level was 354 µmol/L. Lumbar magnetic resonance imaging examination showed postoperative changes, with L5 anterior spondylolisthesis and L4/5, L5/S1 disc bulging.

LESSONS: Lumbar spinal gout is quite rare, and may go unnoticed by physicians. It is accompanied with varying manifestations. If lumbar spinal gout patients present with neurological symptoms or an indeterminate lesion, then surgical intervention can markedly improve symptoms and/or clarify diagnosis.