Small basal cell carcinomas of the trunk are usually regarded as relatively harmless. In contrast, large and ulcerating basal cell carcinomas may become a therapeutic challenge with a less favourable prognosis and high risk of recurrence. The development of mutilating giant basal cell carcinomas appears less due to the biological aggressive character of the tumors, but rather to the patients' attitude of neglect. The case of a 62-year-old patient, featuring such attitude, demonstrates how a common basal cell carcinoma of the trunk can grow over a period of years to a troublesome ulcerating tumor.