Phylloid tumors are extremely rare fibroepithelial tumors that occur during pregnancy. Phyllodes tumors are classified (or classified) into benign, borderline, and malignant. Since its first description in 1838, phyllodes tumors have presented a diagnostic and therapeutic dilemma. We report here the case of a 32-year-old lady presented with an aggressively growing right breast tumor at the 20th week of gestation. She had a history of multiple surgical excisions of the right breast for fibroadenomas, benign phyllodes tumor, recurrent borderline phyllodes tumor, and giant fibroadenoma. She underwent a right simple mastectomy 4 days postpartum for a painful, fungiform, ulcerating right breast tumor. The final histopathological examination was reported as benign phyllodes tumor. Keywords: benign tumor, breast, phyllodes, pregnancy, recurrent. Introduction Phyllodes tumors are rare fibroepithelial tumors that represent 0.3 to 1% of all primary neoplasms and 2.5% of all breast neoplasms (1). The grading (or classification) of phyllodes tumors into benign, borderline and malignant is based on the semi-quantitative evaluation of stromal cellularity, cellular pleomorphism, mitotic activity, the appearance of the margins and stromal distribution (1, 2). It has an overall local recurrence rate of 21%, with a rate of 17%, 25%, and 27% in benign, borderline, and malignant, respectively (1). Borderline and malignant phyllodes tumors have a metastasis rate of 4% and 22%, respectively (1). Since its first description by Johannes Muller in 1838, phyllodes tumors have presented a diagnostic and therapeutic dilemma. Here, we presented a case of recurrent aggressive right benign phyllodes tumor during pregnancy and the management dilemma encountered. Case presentation A 32 year old lady at 28 weeks gestation present...... middle of the sheet... any additional information. The biopsy of the tumor, however, revealed a benign breast disease. Therefore, decisions about the timing and type of surgery were crucial. The timing of the surgery was a difficult consideration. The risk of surgery and general anesthesia during the third trimester of pregnancy may outweigh the benefit for benign breast disease and vice versa for malignant breast disease. Phyllodes tumor can exhibit benign or malignant breast disease behavior. However, a benign phyllodes tumor can grow rapidly and cause local destruction. Therefore, it was a challenging decision when to perform the surgery. The preferred choice of treatment was simple mastectomy because it was a recurrent tumor covering almost the entire breast with discordance in the tumor-to-breast ratio and with the patient's consent for surgery. simple mastectomy.