Abstract The development of multiple large tophi in patients with gout is rare. We report magnetic resonance (MR) and histological features of large subcutaneous tophi in a 32-year-old male patient with no known arthritis. His subcutaneous lesions were confused with a neoplastic process, evaluated by MR imaging, and surgically excised after biopsy. The honeycomb-like appearance on the gadolinium-enhanced images may reflect the characteristic multilobular structure of the tophi composed of avascular urate deposits and surrounding vascularized granulation tissue.