We report a case of a 65-year-old woman with an incidental about 20-mm solitary mass between the lateralsegment of the left lobe of the liver and left kidney 5 years after splenectomy associated with total gastrectomy. The mass wassurgically resected, and histological examination revealed it to be an accessory spleen. Small accessory spleens mostly locatednear the splenic hilus, but large accessory spleens are unusual after total gastrectomy with regional lymph nodes resection. Theremaining accessory splenic tissue would undergo compensatory hypertrophy. Hence, the possibility of accessory spleens mustbe considered when an intra-abdominal mass is identified in a patient with splenectomy associated with gastrectomy
