In this case report, we describe an unusual presentation of gout, manifesting as a fluorodeoxyglucose-avid anterior mediastinal mass mimicking a malignant neoplasm on positron emission tomography/computed tomography. The unusual observation of tophaceous gout in the anterior mediastinum is of relevance to chest physicians and surgeons as well as to radiologists and pathologists evaluating patients with lesions in the mediastinum.
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