So far, computed tomography (CT) and magnetic resonance imaging (MRI) have been used in the detection of basal cell carcinomas (BCC) metastases. We have used PET-CT postoperatively to detect any further metastases of BCC not visible by other techniques. BCC of the trunk are reportedly larger than those located in the head and neck region. These tumors also have a higher incidence of metastasizing. Although it has been suggested in the literature that the TNM (Tumor–Nodes-Metastases) system is not being used routinely for metastasizing BCC. There have been 19 reports of metastasizing BCC of the trunk. We present a case of a 78-year old male patient with large ulcerating metastasizing BCC of the trunk. The literature is reviewed for similar cases and the TNM system is applied.