The average person’s spleen is only about 9 cm. The larger the mass grows, the more it will not only cause rupture of the spleen and hemorrhage, or even death; it may also compress other tissues and organs, causing a wider range of effects. Whether malignant or benign, this mass must be removed despite. However, the mass was right in the middle of the spleen, the gateway to the entry and exit of veins and arteries, which is very rich in blood vessels, and the risk of intraoperative hemorrhage was high. The patient accepted the surgeon’s recommendation for surgery, but offered the possibility of performing the procedure with minimal invasion. After receiving the patient’s “problem”, he also thought about it carefully. Based on experience, it was determined that the mass was probably benign, so the patient was inclined to preserve his spleen. “The spleen is the largest lymphoid organ in the body and plays a huge role in anti-infection and anti-tumor immunity, but a person with a spleen removed has the immunity of a child under the age of 14 and may not even be able to resist a small flu.” In the past, hepatobiliary surgery has done a lot of spleen surgery, both open partial spleen removal and laparoscopic total spleen removal, in favor of no laparoscopic partial spleen removal, why is that? It turns out that the texture of the spleen is like jelly, and it can rupture if you are not careful, and it is also the most difficult organ in the body to stop bleeding. Partial laparoscopic removal of the spleen is undoubtedly a case of looking through the tube. How to carefully bypass the vessels and avoid rupture of the spleen, relying not only on vision but also on the extensive experience of the surgeon, was undoubtedly a bold and innovative move. After much consideration, a complete surgical plan, including how to perform autologous transplantation after spleen rupture, was developed and repeatedly communicated with the patient. In the afternoon of April 25, three small 2-3 cm incisions were made in the patient’s abdomen and the mass was removed with the help of laparoscopic access to the abdomen. To reduce the risk of bleeding, the splenic artery was blocked intraoperatively with a vascular clip. “The block can usually only be performed for 30 minutes, and too much time carries the risk of necrosis or obstruction.” In addition to the mass, about 1 cm of the spleen was cut off during the surgery, and there was almost no intraoperative bleeding. The excised mass was first sent to the pathology department for a frozen pathology section, which turned out to be benign. However, immunohistochemical tests were needed to further determine the pathology, and the patient was both “surprised and delighted” by the results. The patient was shocked that he was suffering from sclerosing angiomatous nodular transformation, a rare splenic non-neoplastic vascular proliferation lesion, with no more than 200 cases reported worldwide since the pathology community identified this disease in 2004. It is a benign lesion that can be cured after resection. In the past, this disease was often misdiagnosed as hemangioma, malignant tumor or inflammatory pseudotumor, and because it was impossible to clearly determine benign from malignant, doctors often had to remove the spleen completely, Cheng Zhiqiang, deputy chief physician of the pathology department, told reporters. “After the first case of sclerosing hemangioma-like nodular transformation was reported by our department in Shenzhen in 2012, all five cases up to now have been reported by us, and the good prognosis of this disease has been clarified through continuous follow-up for many years, which also provides a basis for spleen-preserving surgery for surgeons.”