The basal cell epithelioma (BCE) is the most common type of skin cancer in light-complected individuals. Its incidence correlates with geographic latitude and cumulative sun exposure (1–3), with most basal cell epitheliomas arising on sun-exposed body sites. Two centuries of migrations of fair-skinned Europeans to sunnier lands have made it more common (4). Unlike melanoma and squamous cell carcinoma, BCE only extraordinarily rarely metastasizes; rather it is a local infiltrator that, if neglected, may invade and destroy its underlying structures. The BCE is derived from incompletely differentiated immature keratinocytes of the epidermis or cutaneous appendages. As such, it has been viewed by some as a locally aggressive hamartoma. This view is supported by the general lack of cellular dysplasia, but is contradicted by its rare metastatic behavior.