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Metastatic basal cell carcinoma: a frequent disease with rare clinical evolution. Basal cell carcinoma (BCC) is the most common malignancy worldwide. BCC has a benign evaluation, despite the high rate of local recurrence. Conversely, metastatic BCC (mBCC) is extremely rare. In this article, we present a case of an 86-year-old woman with a history of forearm mBCC, excised in 2009. In 2011, she experienced a left axilla enlargement and the evaluation revealed metastasis of mBCC. The patient began chemotherapy but had regional progression. After she had undergone radiotherapy, initiation of a clinical phase II trial was proposed, which she refused. The patient died in March 2013, 17 months after metastases diagnosis. mBCC poses a significant management challenge and current treatment options are limited. The gold standard treatment is surgical excision. Given the rarity of metastatic spread of cancer and the limited effectiveness of cytostatic agents, it has been a challenge to treat these types of patients.