Basal cell carcinoma (BCC) is the most common malignancy worldwide and is characterized by invasive growth and local tissue destruction. Cure rates for BCC exceed 90% with most treatment modalities. Metastasizing BCC (MBCC) is a rare complication of BCC with high morbidity and mortality rates. We report the case of a 66-year-old man with a large ulcerative lesion on the left side of the flank that was histopathologically diagnosed as a BCC. Clinical and imaging evaluations revealed substantial local invasion with regional lymph node, lung, liver, bone marrow, and bone metastasis. The patient died 7 months after the diagnosis was made. Potentially metastasizing BCCs cannot be definitely identified; thus early intervention with adequate treatment of all BCCs is advised
