Metastasis of basal cell carcinoma (BCC) rarely occurs. Few cases have been reported in the literature; those cases reported generally resulted from chronic, extensive, recurrent lesions on the head or neck. Metastases may involve lymph nodes, the lungs, and bone, as well as abdominal viscera. Once distant metastasis takes place, survival usually is short and palliative treatment is sought. With regard to bone metastases, several case reports have demonstrated similar clinical features indicative of osseous involvement. We present a case report of a patient with an extensive BCC with histologic documentation and probable bone metastasis of BCC. Clinical and radiographic features of this case were consistent with previously reported patients. However, confirmatory postmortem biopsy of the bone specimen was refused by the patient's family.