An accessory spleen in the region of the spermatic cord is a very rare entity so that preoperative screening with splenic scintigraphy is not indicated. Sonographically there will always be the suspicion of a malignant tumor so operative exploration of the testes is the therapy of choice. However, it should always been borne in mind that such rare entities can occur in the region of the spermatic cord and if there is any doubt about the identity of the mass an intraoperative rapid section should be performed because in the case of an accessory spleen ablation of the testes is not necessary.