Surgical excision is the most common treatment for basal cell carcinomas (BCCs). As clinicians, is important to think laterally when suspicious for causes of high burden of non-melanoma skin cancer (NMSC) in absence of immunosuppression. Gorlin’s syndrome is a rare but important autosomal dominant condition related to the PTCH1 tumour suppressor gene, that pre-disposes individuals to developing numerous of BCCs including but not limited to cutaneous skin, intracranial and intra ophthalmic deposits, calcification of falx cerebri and more. 2 Clinical presentations include BCCs at young age, superficial pits on glaberous skin, bony jaw cysts, and appearance of pustular telangiectasia on skin. Testing including genetic markers, skeletal surveys, MRI brain, OPG XRAY to investigate for manifestations of disease. A multi-disciplinary approach is often required with dermatology, genetic testing, plastic surgery, ophthalmology. Treatment for Gorlin’s goes beyond surgical excision due to non-cutaneous manifestations and burden of numerous BCCs. A combination of surgical excision, Moh’s surgery, cryotherapy, laser treatment or immunologic agents such as Vismodegib can be used. As surgeons it is prudent to look beyond the knife when treating NMSCs to provide holistic surgical care. 1. Australia, Cancer Council. Non-melanoma skin cancer. [Online] 2025. https://www.cancer.org.au/cancer-information/types-of-cancer/non-melanoma-skin-cancer 2. A multidisciplinary approach to the successful management of Gorlin syndrome . Ryan N. Mello, Zaki Khan, Umar Choudry. 6, s.l. : Journal of Surgical Case Reports, 2017, Vol. 2017.