Interestingly, none of the described subsequent malignancies in our cohort were ones commonly associated with SUFU or PTCH1 germline alterations.24 If not undertaken at initial diagnosis, a genetic referral at the time of relapse is critical to integrate the risk of basal cell carcinoma or meningioma associated with Gorlin syndrome and radiation exposure.26–28. Here, PTCH1 is linked to nevoid basal cell carcinoma syndrome.