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Context Generally, ectopic splenic tissue such as an accessory spleen is reported to have an incidence of 10% in the general population. However, an intrapancreatic accessory spleen has seldom been reported and cyst formation of the intrapancreatic accessory spleen is extremely rare. Case report A 26-year-old female patient with no clinical manifestations presented with a cyst in the tail of the pancreas which had been diagnosed by ultrasonography. A spleen-preserving distal pancreatectomy was performed with the presumptive diagnosis of a mucinous cystic tumor originating from the pancreas. The intraoperative frozen section showed the possibility of serous cystadenoma of the pancreas. The pathological examination revealed the cyst to be stratified squamous epithelium and was surrounded by splenic tissue and the final diagnosis was epithelial splenic cyst in an intrapancreatic accessory spleen. Conclusion Although great progress has been made with modern imaging techniques, it is still difficult to make a definitive diagnosis of cystic lesions in the pancreas.