Introduction: Chronic tophaceous gout classically occurs after 10 years or more of recurrent polyarticular gout. However, tophi can also occur as first sign of the disorder.
Case report: We report the case of a 60 year female with tophaceous involvement of the pubis bone which is an unusual location for this type of pathology without any prior manifestation of gouty arthritis.
Conclusion: Tophi can present in unexpected locations, even as the first sign of gout, often mimicking infection and neoplasia and vigilance is required when unusual symptoms or signs occur in a patient with gout.
Keywords: Gout; Pubis Bone; Tophus.