Gallbladder cancer is a highly fatal disease with poor prognosis; indeed a high proportion of tumours is diagnosed at advanced stage. Metastases are commonly detected in regional lymph nodes, liver and peritoneum, but unusual sites of spread as thyroid and breast have also been described in literature. We report a case of unsuspected muscle metastases, associated to pulmonary metastases, detected by FDG-PET/CT in a patient with previously removed gallbladder cancer and persistent episodes of hemoptysis.