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.