Cardiac metastasis of squamous cell carcinoma (SCC) of the tongue is rare. This report presents a known case of SCC of the tongue in a patient who was admitted with an initial diagnosis of pneumonia and endocarditis and had received wide spectrum antibiotics. Due to the lack of an appropriate response, surgical valve replacement was initially considered, but further evaluation by cardiac MRI revealed multiple cardiac, lung and paravertebral metastases, most probably from the previous SCC and as such the patient was managed conservatively. This case report highlights the importance of cardiac MRI for evaluating head and neck tumors and choosing optimal treatment plans.
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