Pseudoangiomatous stromal hyperplasia (PASH) is a lesion that is often discovered incidentally in breast biopsies performed for benign or malignant lesions of the breast. More rarely, it may present as a palpable lesion. The term "Pseudoangiomatous" has been proposed to underline its particular histological aspect simulating a vascular proliferation. We report a case of PASH in a 42-year-old female patient presenting as a recurrent lesion that resulted in a considerable and rapid increase in breast volume (135 x 100 x 97mm) requiring a large lumpectomy with muscular-fat remodeling. Angiosarcoma and fibroadenoma remain the main differential diagnoses. Anatomopathological examination allows us to eliminate them, in particular through immunohistochemistry.