Leiomyosarcoma of the inferior vena cava is a rare malignant tumor with a poor prognosis. We report a case of a 39-year-old woman admitted for a surgical resection of a retroperitoneal mass revealed by pain localised in the right lumbar fossa. Computed tomography of the abdomen revealed a heterogeneous retroperitoneal mass compressing the inferior vena cava. Surgical resection was performed with the reconstruction of the inferior vena cava using a Dacron prosthesis, the diagnosis of vessel wall leiomyosarcoma was revealed by histopathology. Surgical resection with clear margins remains the only treatment offering the best survival rate. The complex nature of the surgery of those tumors is a major therapeutic challenge for surgeons.

The recent awareness of the spleen's important role, especially its immune function, has fundamentally changed the management of splenic diseases, promoting the splenic preserving surgery, and protecting from the significant risk of total splenectomy: overwhelming post-splenectomy sepsis. Partial splenectomy is a safe and feasible technique that offers, according to the literature, the same results of a total approach, either in achieving hematological benefits in congenital hemolytic anemia, or treating the focal splenic lesion such as hemangioma, while preserving the immune function.