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+A 33-year-old man presented with left flank dull ache.
+On the abdominal computed tomography, a solid renal mass in the upper portion of the left kidney was identified.
+The mass was measured 2.8 cm × 2.8 cm × 2.5 cm in size, was well-defined.
+The patient had no other abnormal findings, such as suspected distant metastasis or lymph node metastasis.
+Radical nephrectomy was performed on 14/9/2005.
+On gross examination, the nephrectomy specimen measured 11.5 cm × 6.5 cm × 4.5 cm and the tumor was a solid, grayish-brown mass measured 3.5 cm × 2.5 cm × 2.2 cm in size.
+Histologic examination demonstrated trabecular and ribbonlike patterns with minimal fibrotic stroma.
+The cytoplasm was granular and eosinophilic with uniform round to oval nuclei with finely stippled chromatin and inconspicuous nucleoli.
+Mitoses were not found (0 per 10 high-power fields) on H&E stain.
+The final pathologic examination revealed a well-differentiated neuroendocrine (carcinoid) tumor confined to the kidney (Fig.1).
+Immunohistochemical stains demonstrated labeling with chromogranin, neuron-specific enolase and synaptophysin (Fig.2), and the proliferation index was less than 2 % as measured by immunohistochemistry for Ki-67.
+Further radiation and chemotherapy were not received.
+Nine years after radical nephrectomy, computed tomography of the abdomen demonstrated a 2 cm × 1.8 cm cyst mass in the right liver and multiple high density shadow in gallbladder.
+No enlarged lymph nodes were found in the abdominal cavity.
+Cholecystectomy and extirpation for hepatic cyst were performed by laparoscopy surgery.
+Histologic examination demonstrated trabecular and glandlike growth (Fig.3), moderate and uniform nuclei and mitoses weren't found (0 per 10 high-power fields).
+Advanced immunohistochemistry revealed that the lesion was positive for synaptophysin (Fig.4) and CD56, but negative for chromogranin and neuron-specific enolase.
+These features are supported in a neuroendocrine tumor.
+Due to the similar pathologic characteristics between the primary renal carcinoid tumor and liver tumor.
+The final pathology report indicated a carcinoid tumor of the left kidney with liver metastasis.