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RET-fusions are a known cause of acquired osimertinib resistance in patients with advanced NSCLC. Herein we describe the case of a patient who developed resistance to osimertinib, via acquisition of a novel CGN-RET fusion mutation. She had a favorable response to treatment with RET-targeting TKI selpercatinib, in combination with osimertinib.

Dissemination of tuberculosis (TB) is known as miliary tuberculosis. When miliary tuberculosis lacks classic radiographic and clinical features, it can be labeled cryptic miliary tuberculosis and may mimic metastatic cancer. This unusual presentation of an already atypical form of TB often delays diagnosis. We present a case of a 58-year-old female who presented with presumed metastatic carcinoma, who was ultimately diagnosed with both primary breast cancer and disseminated TB. This case emphasizes the need for a high index of suspicion for miliary tuberculosis in patients with presumed or proven malignancy.