Accessory splenic tissue may be found associated with the testis.
Features of intrascrotal accessory spleen:
(1) reddish mass found in a paratesticular position (within the tunica vaginalis testis)
(2) presence of benign splenic tissue on histology
The splenic tissue may reach the scrotum in 2 ways:
(1) during fetal development. The testis initially develops within the abdomen, only later descending into the scrotum. In some cases a fibrous band can be identified running from the inferior pole of the spleen to the paratesticular mass
(2) splenic rupture with a small fragment of splenic tissue descending through a hernia into the scrotum
Problems can arise if:
(1) it is assumed that it is a malignant testicular tumor and a proper evaluation is not performed.
(2) it presents as acute scrotal pain following torsion
(3) it develops a splenic tumor
