Cardiac valves are the most commonly victimized sites of infective endocarditis. The vegetations migrating outside the valves are quite rare. Echocardiography is a sensitive method for detecting these lesions. We report a case of unusual echocardiographic presentation of infective endocarditis. Transesophageal echocardiography showed a giant tonguelike echogenic mass, which attached to the posterior wall of left atrium without involving the mitral valve. Also, we discuss the differential diagnosis of infective endocarditis and myxoma, as well as the considerations of anesthetic management of intracardiac mass.