Renal carcinoid is an exceedingly rare tumor. About 20% of cases arise in patients with horse-shoe kidneys. Some cases occur in the setting of a renal teratoma. Presenting symptoms usually include back/flank pain, hematuria, and enlarging abdominal mass. Carcinoid syndrome is extremely uncommon. The tumor is usually solitary, well-demarcated (as shown here), solid, and yellow-tan in appearance.