Splenosis is a benign condition caused by implant of splenic tissue after trauma or surgery. It is usually an incidental finding, but may be commonly confused as metastatic cancer on abdominal imaging. This is a case of a 48-year-old female with a history of splenectomy after a motor vehicle accident 40 years ago, who presented to the hospital with a 1 week history of epigastric pain, diarrhea, and a 10 pound weight loss. Physical examination revealed epigastric tenderness. Laboratory tests were normal and stool studies negative. CT scan confirmed a 3.3 x 3.0 x 2.9 cm intrapancreatic tail mass, 2 small masses in the left upper quadrant adjacent to the colon and between the stomach and colon, a 4.3 x 3.3 x 4.8 cm extrinsic mass in the midline right upper quadrant anteriorly adjacent to the left hepatic lobe with mass effect on the liver, 3 small low-attenuation lesions within the liver, 4.6 cm peripherally calcified uterine mass, and 4 cm right adnexal mass. There was a concern for metastatic cancer. CA 19-9, CEA, CA 125, AFP were normal. With the patient's history of splenectomy, splenosis was a consideration and a sulfur colloid scan showed normal uptake by the liver, a few small areas of increased activity in the left upper quadrant compatible with splenosis, however there was a space-occupying cold defect overlying the left lobe of the liver corresponding to the CT finding which did not represent splenosis. Biopsy of this lesion confirmed benign lymphoid tissue with small lymphocytes. On outpatient follow up, she underwent EUS with pancreatic mass biopsy which showed benign tissue and biopsy of the liver, grade I neurendocrine tumor. Further work up is in progress. Splenosis should be considered in the differential diagnosis when multiple tumor-like lesions appear on abdominal imaging in a patient with a splenic injury or splenectomy previously. They are usually asymptomatic, but may be a cause of hemorrhage or small bowel obstruction. Splenic implants may be located anywhere in the peritoneal cavity. Novel, noninvasive radiologogic testing modalities such as the Technetium (Tc) 99m radionuclide scanning, can assist in the diagnosis of splenosis. Once the diagnosis is made, no further testing needs to be completed unless the patient is symptomatic. Although rare, splenosis is a differential diagnosis to keep in mind in patients with the appropriate risk factors. In this patient, she interestingly had concomitant malignancy in addition to splenosis.