Ectopic splenic tissue can present as accessory spleens and splenosis. While accessory spleens are congenital and more common; splenosis occurs as a result of implantation of splenic tissue as a result of trauma or iatrogenic injury. Only up to 40 intrathoracic splenosis have been reported in the English language literature to date. Here we discuss a case in which Para oesophageal pre-aortic ectopic splenic tissue was identified through radionuclide imaging 20 years after splenic rupture in a 44-year-old male for work up of epigastric pain. Splenosis should be considered as differential diagnosis in all previously splenectomised patients who present with unexplained masses on imaging. Early diagnoses with preoperative non-invasive radionucleotide scanning with collateral histories can prevent unnecessary surgery and reduce expensive and invasive investigations.
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