• Hui Lu, Qiang Chen, and Hui Shen.
• Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R. China Department of Hand Surgery, Zhejiang Province People's Hospital, Hang Zhou, Zhejiang Province, P.R. China.
• Medicine (Baltimore). 2017 Mar 1; 96 (9): e6245e6245.

RationaleGouty tophi is a rare cause of CTS. We first report a unique case of repeated CTS with gouty tophi in flexor tendon. In the previous literature, the symptoms cases of CTS were gradually increased.Patient ConcernsWe report a 44-year-old male porter presented with mass on his left distal forearm combined a repeated carpal tunnel syndrome for 5 years. He felt numbness in fingers and his left palmar. The CTS symptoms had been eased through rest and dugs medication. It recurred twice.DiagnosesMonosodium urate crystal deposits were found in surgery. Histologic findings confirmed the diagnosis of gout.InterventionsWe removed partial of gouty tophus and retained the integrity of the tendon.OutcomesTwo years after the surgery, the patient had not experienced any symptom recurrence.LessonsEarly diagnosis and control of gout are necessary to avoid irreversible complications. The surgery combined with decreasing trioxypurine treatment can improve the treatment outcome of gouty tophus.

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