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Objective:  The ischiorectal fossa is a key anatomical location with boundaries and internal structures owing distinct contributions to function and quality of life.  Methods:  We highlight the importance of management of pathology in this deep anatomically complex location.  Results:  We present a ten-step multidisciplinary surgical approach; achieving en bloc radical excision with primary closure and reassuring outcomes. Schwannomas are benign slow-growing nerve sheath tumors.  Conclusions:  Pelvic schwannomas are rare with only 3 reported cases of the pudendal nerve. We also offer an overview of this rare pathology whilst acknowledging a paucity of recommendations regarding management of disease of the ischiorectal fossa.

Ten-Step Surgical Approach to Management of Pathology of the Ischiorectal Fossa—A Review of the Literature and Application in a Rare Pelvic Schwannoma