Conclusion
PBOS is an extremely rare malignancy with divergence among authors’ opinions regarding its histogenesis and management. Uncertainty about the origin of PBOS and whether it is a metaplastic transformation of epithelial cells or pre-existing lesions such as phyllodes tumors or even arising directly from totipotential stem cells are part of the scenario that has made the dilemma even worse.
In addition, there is not a comprehensive and widely accepted management guideline for its management. Some of the cases received all three parts of possible treatments including surgery, chemotherapy, and radiotherapy; however, there are so many cases that received only one item.
We believe that the most important reason for this discrepancy is not having an agreement about the origin of the tumor; as a result, many authors have approached this tumor similar to a sarcoma while others have tried to manage it like an epithelial-originated malignancy.
Using a comprehensive IHC panel and meticulous pathological evaluation of the tumor would be helpful to find the best plan of treatment meanwhile it is worth mentioning that reporting each case and publishing them would be valuable to collect more information about this specific type of malignancy.