A Case of ROS1-Fusion Non-Small Cell Lung Cancer with Acquired BRAF Mutation Developing Unusual Skin Metastasis.

•Our case presents a female patient with a rare cutaneous metastasis of her ROS1-fusion NSCLC with acquired BRAF V600E mutation on ROS1 TKI.•The BRAF V600E introduced putative bypass track resistance to ROS1 TKI, leading to further disease progression.•Bypass tract mechanisms also play in important role in ROS1 TKI resistance in addition to classically described ROS1 on-target resistance mutations such as ROS1 G2302R.