Pheochromocytoma (PCC) is a challenging and life-threatening neoplasm. Herein, the authors report an interesting and unexpected solution for a clinical case concerning a patient with a PCC, who developed delayed ectopic adrenocorticotropic hormone Cushing syndrome originating from the PCC. In addition, after a misleading I-labeled metaiodobenzylguanidine single-photon emission computed tomography/computed tomography, an F-fluorodeoxyglucose positron emission tomography/computed tomography, executed to confirm the diagnosis of PCC, showed a silent pulmonary nodule that unexpectedly turned out to be a lung nocardiasis.