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(a-c) MRI of the pelvis showing large mass involving the anal sphincter.
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HPE from the operation confirmed the diagnosis of mucinous adenocarcinoma, well differentiated with no LN involvement (Figure 1).
(a-c) Preoperative marking of VRAM flap and en bloc resection.
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Perineal incision was performed with R0 en bloc resection of the tumour along with coccygectomy (Figure 2).
(a-c) Harvested rectus flap tunnelled into the pelvis.
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The flap was secured by a multilayered closure using absorbable and nonabsorbable sutures (Figure 3).