Disclosure All authors disclosed no financial relationships relative to the content of this work. Commentary Pancreatic gout is a rare manifestation of tophaceous gout, which can mimic pancreatic ductal adenocarcinoma. Although the authors successfully persisted and obtained a diagnosis of pancreatic gout, it should be noted that neuroendocrine tumors and pancreatic ductal adenocarcinoma are more common causes in patients presenting with a pancreatic tail mass. Nonetheless, a simple therapy—that prevented unnecessary studies or even surgery—was able to provide almost complete resolution of this mass. However, the question remains whether this patient warranted urate-lowering treatment in the context of an asymptomatic lesion. Sergio A. Sánchez-Luna, MD, Co-Director, Bariatric and Surgical Endoscopy Program, Basil I. Hirschowitz Endoscopic Center of Excellence, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA Mohamed O. Othman, MD, GIE Senior Associate Editor