Conventional Skull Base Chordoma in a Ugandan Adult Male, Presenting with Prolonged Headache: A Case Report.
7 affiliations
- 1Department of Pathology, C-Care IHK Uganda, Kampala, Uganda.
- 2Department of Pathology, Mulago National Referral Hospital, Kampala, Uganda.
- 3Department of Pathology, St. Mary's Hospital Lacor, Gulu, Uganda.
- 4Department of Pathology, Makerere University, Kampala, Uganda.
- 5Department of Radiology, C-Care IHK Uganda, Kampala, Uganda.
- 6Department of Radiology, Uganda Cancer Institute, Kampala, Uganda.
- 7Department of ENT, C-Care IHK Uganda, Kampala, Uganda.
Abstract
Background
Chordomas are uncommon malignant neoplasms arising from notochordal remnants, most commonly affecting the axial skeleton, mainly the skull base and sacrococcygeal region. Skull base chordoma may be asymptomatic or cause progressive headache before focal symptoms prompt imaging. In resource-limited settings, diagnostic work-up is often prolonged as the patient is managed with analgesics without prompt and satisfactory investigation. We report a case of conventional Chordoma arising at the skull base, in a patient with long standing headache.Case presentation
A 49-year-old man presenting with a more than one-year history of intermittent and progressive worsening headache. After he reported an episode of facial numbness, examination documented preserved facial sensation. There was no other focal neurological clinical abnormality. Head CT imaging revealed an expansile, destructive midline skull base mass (bone erosion) occupying the region of the skull base, sphenoid paranasal sinus extending into the ethmoid. An invasive biopsy through the sphenoid sinuses was obtained for histopathologic evaluation, which showed morphology consistent with chordoma, supported by IHC showing positivity for EMA, pan-cytokeratin, and S100, with negative CK7, CK20, and CD34. The Ki-67 proliferation index was less than 5%. The integrated findings strongly supported conventional chordoma. Brachyury was unavailable. At last documented review, the patient was clinically stable and surgical management was planned; however the patient was lost to follow-up on subsequent attempts.Conclusion
Progressive headache with a newly reported focal neurological symptom warrants appropriate imaging and specialist assessment. In a destructive midline skull base mass, the combined morphology and immunophenotype strongly support chordoma, while the absence of brachyury confirmation remains a limitation.
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BibTeX
@article{okello2026conventional,
title = {{Conventional Skull Base Chordoma in a Ugandan Adult Male, Presenting with Prolonged Headache: A Case Report.}},
author = {Malcom Mark Okello and Male Mutumba and Sam Kalungi and Sharrif Musoke and Phillip Omega and Esther Fiona Wanyenze and Eunice Chepkurui Byebei and Ivan Asiimwe and Alfed Bulamu and Mark Kirabo Iga and Stella Nabawanga and Gerald Alicwamu and Melisa Nalwanga and Cosmas Jerome Mbogga and Boaz Mwesigwa},
journal = {International medical case reports journal},
year = {2026},
month = oct,
doi = {10.2147/imcrj.s626932},
url = {https://europepmc.org/article/MED/42921509},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Conventional Skull Base Chordoma in a Ugandan Adult Male, Presenting with Prolonged Headache: A Case Report.
AU - Malcom Mark Okello
AU - Male Mutumba
AU - Sam Kalungi
AU - Sharrif Musoke
AU - Phillip Omega
AU - Esther Fiona Wanyenze
AU - Eunice Chepkurui Byebei
AU - Ivan Asiimwe
AU - Alfed Bulamu
AU - Mark Kirabo Iga
AU - Stella Nabawanga
AU - Gerald Alicwamu
AU - Melisa Nalwanga
AU - Cosmas Jerome Mbogga
AU - Boaz Mwesigwa
PY - 2026
DA - 2026/10/19
JO - International medical case reports journal
DO - 10.2147/imcrj.s626932
UR - https://europepmc.org/article/MED/42921509
AB - Background Chordomas are uncommon malignant neoplasms arising from notochordal remnants, most commonly affecting the axial skeleton, mainly the skull base and sacrococcygeal region. Skull base chordoma may be asymptomatic or cause progressive headache before focal symptoms prompt imaging. In resource-limited settings, diagnostic work-up is often prolonged as the patient is managed with analgesics without prompt and satisfactory investigation. We report a case of conventional Chordoma arising at the skull base, in a patient with long standing headache.Case presentation A 49-year-old man presenting with a more than one-year history of intermittent and progressive worsening headache. After he reported an episode of facial numbness, examination documented preserved facial sensation. There was no other focal neurological clinical abnormality. Head CT imaging revealed an expansile, destructive midline skull base mass (bone erosion) occupying the region of the skull base, sphenoid paranasal sinus extending into the ethmoid. An invasive biopsy through the sphenoid sinuses was obtained for histopathologic evaluation, which showed morphology consistent with chordoma, supported by IHC showing positivity for EMA, pan-cytokeratin, and S100, with negative CK7, CK20, and CD34. The Ki-67 proliferation index was less than 5%. The integrated findings strongly supported conventional chordoma. Brachyury was unavailable. At last documented review, the patient was clinically stable and surgical management was planned; however the patient was lost to follow-up on subsequent attempts.Conclusion Progressive headache with a newly reported focal neurological symptom warrants appropriate imaging and specialist assessment. In a destructive midline skull base mass, the combined morphology and immunophenotype strongly support chordoma, while the absence of brachyury confirmation remains a limitation.
SN - 1179-142X
ER -