Leiomyosarcoma of the ischiorectal fossa: report of a novel sphincter and sciatic nerve sparing simultaneous trans-abdominal and trans-gluteal resection and review of the literature.

Leiomyosarcomas are rare tumours of smooth muscle origin, and there have been no reported cases of such tumours arising within the ischiorectal fossa. Surgical resection with clear margins remains the gold standard treatment; however, there is limited literature on surgical approaches to the ischiorectal fossa for such tumours. We report a case of a high-grade leiomyosarcoma in a 59-year-old lady, occurring within the ischiorectal fossa that was managed using a novel simultaneous sphincter and sciatic nerve preserving trans-abdominal and trans-gluteal technique. This novel approach could be utilized not only for sarcomas but also for other tumours of the ischiorectal fossa extending into the gluteal region.