The incidence of skeletal Muscle metastases is reported to be less than 1% of metastases of haematogenous origin. Distant skeletal muscle metastases from head and neck squamous cell carcinomas are exceedingly rare. Only a case with tongue carcinoma metastasized to paravertebral muscles, has been reported so far. The reasons for the rarity of metastatic involvement of skeletal muscle are still unclear. The presence of skeletal muscle metastases in the setting of disseminated disease offers no hope for Curative treatment. We report an unusual case of a 63-year-old patient with tongue carcinoma metastasizing to the left shoulder Muscles. To our knowledge, this is the first such case to be reported in the English medical literature. (C) 2007 Elsevier Ireland Ltd. All rights reserved.