An incidentaloma is a mass lesion incidentally found, of uncertain significance, and clinically inert. Although incidentaloma is commonly referred to designate an adrenal lesion, it can denote any incidental lesion of other organs. We describe the unexpected finding of an ileum neuroendocrine incidentaloma detected by 6-L-(18F)-fluorodihydroxyphenylalanine (FDOPA) PET/CT performed in an asymptomatic patient with history of sporadic medullary thyroid carcinoma and biochemical suspicion of recurrent disease. This report underlines the high FDOPA PET/CT sensitivity for neuroendocrine tumor detection and the need of complementary diagnostic investigations elucidating the significance of extraphysiological FDOPA intestinal uptake, even in patients with unrelated primary cancer.