Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. Unlike phyllodes tumors, they do not present with a leaflike architecture, rendering a biopsy diagnosis of a PST very challenging. In this report, we compare the histopathological features of a PST with those of a borderline phyllodes tumor. We discuss the differences and similarities between both entities, and we highlight the potential pitfalls of the respective biopsies. Both cases illustrate that PSTs and phyllodes tumors are part of the same spectrum. This biological spectrum implies that “hybrid” lesions do exist, which can be hard to classify.
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