To report the case of a 29-year-old patient presenting with renal splenosis along with a complete review of literature on this condition. Splenosis is a frequent condition following abdominal trauma or splenectomy, described as splenic tissue that autotransplants into a heterotopic location. However, renal splenosis is rare and often mistaken with renal carcinoma.

The patient was initially referred to our department for a renal mass incidentally discovered on ultrasound. Further investigation included with computed tomography and magnetic resonance imaging.

Imaging features revealed a well circumscribed solid renal mass, exhibiting an isosignal on T1- and T2-weighted sequences in comparison with the renal cortex. The mass exhibited a heterogeneous enhancement on the arterial and portal phases, homogeneous patterns during the delayed phases, and high signal intensity on diffusion-weighted images. A partial nephrectomy was performed and pathological examination revealed the final diagnosis of renal splenosis.

Imaging features alone do not provide a definitive diagnosis of splenosis but suggestive past history associated with imaging findings consistent with splenic tissue should lead to ^99m technetium-sulfur colloid scanning or ferumoxid-enhanced MRI to avoid useless surgery.