Points •Although the diagnosis of phyllodes tumor (PT) is not challenging, a comprehensive histopathological examination with multiple sampling when considering the coexistence with carcinoma is necessary.• Not only full examination of the stromal component, but also meticulous microscopic examination, may be useful to detect a possible invasive focus of epithelial origin.
•The presence of ductal carcinoma in PTs is clinically significant as it may alter treatment.• Surgeon, radiologist and pathologist should take great care in phyllodes tumors larger than 4 cm and showing sudden growth.