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Pelvic imaging showed an 8\u2010cm sized lesion in the lower rectovaginal septum. Transvaginal biopsy and immunohistochemical analysis were performed. After three courses of carboplatin\u2010paclitaxel\u2010bevacizumab therapy, the mass reduced by half. Subsequently, laparoscopic excision with transanal total mesorectal excision, and radical hysterectomy were performed. The anus was preserved, and dysuria improved within a month. The final histopathological diagnosis was carcinosarcoma of the rectovaginal septum from an uncertain origin, presumably endometriotic or mesonephric. Twelve months following surgery, solitary liver metastasis was confirmed; however, there was no evidence of local recurrence. Total mesorectal excision following platinum\u2010based neoadjuvant chemotherapy may be an ideal treatment for gynecological malignancies in the rectovaginal septum, especially for large tumors localized deep into the pelvis.<\/jats:p>","DOI":"10.1111\/jog.15487","type":"journal-article","created":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T05:27:10Z","timestamp":1668230830000},"page":"763-768","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transanal total mesorectal excision for primary rectovaginal carcinosarcoma: A case report and literature review"],"prefix":"10.1111","volume":"49","author":[{"given":"Takuto","family":"Onishi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Omihachiman Community Medical Center  Omihachiman Shiga 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