Hyperechogenicity on breast ultrasonography is strongly associated with benignity.
However, breast cancers may rarely appear as hyperechoic masses. These include lymphoma, angiosarcoma,
liposarcoma, and metastatic cancers. Phyllodes tumors are fibroepithelial neoplasms
that can be benign, borderline, or malignant. Malignant phyllodes tumors account for less than 1%
of all breast malignancies, and heterologous differentiation in these tumors is occasional. This case
report describes a 25-year-old woman who has malignant phyllodes tumors with heterologous sarcomatous
elements that appear as hyperechoic masses sonographically and present a review of the