Microangiopathic haemolytic anemia (MAHA) complicates occasionally clinical evolution of disseminated tumors, usually adenocarcinoma-type, but is association with a squamous cell cancer of head and neck origin is rare. Additionally, head and neck cancer is an unusual origin of cardiac metastases. We present a patient with head and neck squamous cell cancer who developed intravascular haemolysis with thrombopenia. Postmortem study showed tumor cells into the heart and tumor emboli in pulmonary arterioles, the later often described in the cases of MAHA. We discuss the physiopathology of MAHA and its association with cancer. We briefly discuss epidemiology and pathogeny of cardiac metastases.