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Radiation-Induced Morphea of the Breast in a Patient with Pre-Existing Mycosis Fungoides: A Diagnostic Challenge

Year: 2026

Type: article

Abstract: Radiation-induced morphea (RIM) is a rare, immune-mediated late complication of breast radiotherapy that may clinically mimic radiation fibrosis, malignancy, or other inflammatory dermatoses. Diagnosis is particularly challenging in patients with pre-existing cutaneous T-cell lymphoma (CTCL), in whom new post-radiation skin lesions may raise concern for lymphoma involvement or progression. To the best of our knowledge, based on a non-systematic search of the available literature, this is the first reported case of radiation-induced morphea occurring in a patient with pre-existing mycosis fungoides (MF). A 55-year-old woman with a history of MF and right breast invasive lobular carcinoma underwent bilateral mastectomy followed by adjuvant chest wall radiotherapy. Approximately 6.5 years later, she developed a progressive erythematous, indurated plaque within the irradiated field. Given her history of MF, cutaneous lymphoma involvement and radiation-associated sarcoma were important diagnostic considerations. Punch biopsy demonstrated dermal collagen homogenization with a mixed inflammatory infiltrate, while immunohistochemistry showed preserved pan-T-cell antigen expression without an aberrant phenotype, supporting RIM rather than lymphoma. The patient was treated with topical corticosteroids followed by methotrexate, with mild-to-moderate improvement in erythema without complete resolution; subsequent reconstructive revision was followed by further improvement in erythema, breast softness, and cosmesis. This case highlights the diagnostic overlap between RIM and CTCL and underscores the importance of prompt biopsy and careful clinicopathological correlation in evaluating persistent or atypical post-radiation skin changes.

Source: Current Oncology

DOI: 10.3390/curroncol33090509

Authors: Tala Mobayed, Toufic Eid, Ossama Abbas, Hiba Moukadem, Nagi El Saghir, Zeina Ayoub

Institutions: American University of Beirut Medical Center, American University of Beirut

Language: English

Topic: Cutaneous lymphoproliferative disorders research

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,654